WordNet
- relating to or involving the stomach; "gastric ulcer" (同)stomachic, stomachal
- malignant tumor originating in glandular epithelium (同)glandular cancer, glandular_carcinoma
PrepTutorEJDIC
- 胃の,胃に発生する
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/07/05 13:39:12」(JST)
wiki en
| Gastric cancer | |
|---|---|
| Classification and external resources | |
A suspicious stomach ulcer that was diagnosed as cancer on biopsy and resected. Surgical specimen kept for educational purposes. |
|
| ICD-10 | C16 |
| ICD-9 | 151.9 |
| OMIM | 137215 |
| DiseasesDB | 12445 |
| eMedicine | med/845 |
| MeSH | D013274 |
Stomach cancer, or gastric cancer, refers to cancer arising from any part of the stomach. Stomach cancer causes about 800,000 deaths worldwide per year.[1]
Contents
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Signs and symptoms
Endoscopic image of linitis plastica, a type of stomach cancer where the entire stomach is invaded, leading to a leather bottle-like appearance with blood coming out of it.
Endoscopic image of early stage of the stomach cancer. Its histology was poorly differentiated adno carcinoma with signet ring cells.Left above=Normal, right above=FICE, left low=acetate stained, right low= AIM stained
Stomach cancer is often asymptomatic or causes only nonspecific symptoms in its early stages. By the time symptoms occur, the cancer has often reached an advanced stage (see below), one of the main reasons for its poor prognosis.[citation needed] Stomach cancer can cause the following signs and symptoms:
Stage 1 (Early)
- Indigestion or a burning sensation (heartburn)
- Loss of appetite, especially for meat
- Abdominal discomfort or irritation
Stage 2 (Middle)
- Weakness and fatigue
- Bloating of the stomach, usually after meals
Stage 3 (Late)
- Abdominal pain in the upper abdomen
- Nausea and occasional vomiting
- Diarrhea or constipation
- Weight loss
- Bleeding (vomiting blood or having blood in the stool) which will appear as black. This can lead to anemia.
- Dysphagia; this feature suggests a tumor in the cardia or extension of the gastric tumor in to the esophagus.
Note that these can be symptoms of other problems such as a stomach virus, gastric ulcer or tropical sprue.
Causes
Infection by Helicobacter pylori is believed to be the cause of most stomach cancer while autoimmune atrophic gastritis, intestinal metaplasia and various genetic factors are associated with increased risk levels. The Merck Manual states that diet plays no role in the genesis of stomach cancer.[2] However, the American Cancer Society lists the following dietary risks, and protective factors, for stomach cancer: "smoked foods, salted fish and meat, and pickled vegetables (appear to increase the risk of stomach cancer.) Nitrates and nitrites are substances commonly found in cured meats. They can be converted by certain bacteria, such as H. pylori, into compounds that have been found to cause stomach cancer in animals. On the other hand, eating fresh fruits and vegetables that contain antioxidant vitamins (such as A and C) appears to lower the risk of stomach cancer."[3] A December 2009 article in American Journal of Clinical Nutrition found a statistically significant inverse correlation between higher adherence to a Mediterranean Dietary Pattern and stomach cancer.[4]
In more detail, H. pylori is the main risk factor in 65–80% of gastric cancers, but in only 2% of such infections.[5] The mechanism by which H. pylori induces stomach cancer potentially involves chronic inflammation, or the action of H. pylori virulence factors such as CagA.[6] Approximately ten percent of cases show a genetic component.[7] Some studies indicate that bracken consumption and spores are correlated with incidence of stomach cancer, though causality has yet to be established.[8]
A very important but preventable cause of gastric cancer is tobacco smoking. Smoking increases the risk of developing gastric cancer considerably; from 40% increased risk for current smokers to 82% increase for heavy smokers which is nearly twice the risk for non-smoking population. Gastric cancers due to smoking mostly occur in upper part of stomach near esophagus[9][3][10] Another lifestyle cause of gastric cancer besides smoking is consumption of alcohol.[11][12][13] Alcohol along with tobacco smoking increase the risk of developing other cancers as well.
Gastric cancer shows a male predominance in its incidence as up to three males are affected for every female. Estrogen may protect women against the development of this cancer form.[14] A very small percentage of diffuse-type gastric cancers (see Histopathology below) are thought to be genetic. Hereditary Diffuse Gastric Cancer (HDGC) has recently been identified and research is ongoing. However, genetic testing and treatment options are already available for families at risk.[15]
Some researchers[16][17][18][19][20][21] showed a correlation between Iodine deficiency or excess, iodine-deficient goitre and gastric cancer; a decrease of the incidence of death rate from stomach cancer after implementation of the effective I-prophylaxis was reported too.[22] The proposed mechanism of action is that iodide ion can function in gastric mucosa as an antioxidant reducing species that can detoxify poisonous reactive oxygen species, such as hydrogen peroxide.
The International Cancer Genome Consortium is leading efforts to map stomach cancer's complete genome.[citation needed]
Diagnosis
To find the cause of symptoms, the doctor asks about the patient's medical history, does a physical exam, and may order laboratory studies. The patient may also have one or all of the following exams:
- Gastroscopic exam is the diagnostic method of choice. This involves insertion of a fiber optic camera into the stomach to visualize it.
- Upper GI series (may be called barium roentgenogram)
- Computed tomography or CT scanning of the abdomen may reveal gastric cancer, but is more useful to determine invasion into adjacent tissues, or the presence of spread to local lymph nodes.
Abnormal tissue seen in a gastroscope examination will be biopsied by the surgeon or gastroenterologist. This tissue is then sent to a pathologist for histological examination under a microscope to check for the presence of cancerous cells. A biopsy, with subsequent histological analysis, is the only sure way to confirm the presence of cancer cells.
Various gastroscopic modalities have been developed to increased yield of detect mucosa with a dye that accentuates the cell structure and can identify areas of dysplasia. Endocytoscopy involves ultra-high magnification to visualize cellular structure to better determine areas of dysplasia. Other gastroscopic modalities such as optical coherence tomography are also being tested investigationally for similar applications.[23]
A number of cutaneous conditions are associated with gastric cancer. A condition of darkened hyperplasia of the skin, frequently of the axilla and groin, known as acanthosis nigricans, is associated with intra-abdominal cancers such as gastric cancer. Other cutaneous manifestations of gastric cancer include tripe palms (a similar darkening hyperplasia of the skin of the palms) and the sign of Leser-Trelat, which is the rapid development of skin lesions known as seborrheic keratoses.[24]
Various blood tests may be done; including: Complete Blood Count (CBC) to check for anemia. Also, a stool test may be performed to check for blood in the stool.
Histopathology
Poor to moderately differentiated adenocarcinoma of the stomach. H&E stain.
Gastric signet ring cell carcinoma. H&E stain.
Adenocarcinoma of the stomach and intestinal metaplasia. H&E stain.
- Gastric adenocarcinoma is a malignant epithelial tumor, originating from glandular epithelium of the gastric mucosa. Stomach cancers are overwhelmingly adenocarcinomas (90%).[25] Histologically, there are two major types of gastric adenocarcinoma (Lauren classification): intestinal type or diffuse type. Adenocarcinomas tend to aggressively invade the gastric wall, infiltrating the muscularis mucosae, the submucosa, and thence the muscularis propria. Intestinal type adenocarcinoma tumor cells describe irregular tubular structures, harboring pluristratification, multiple lumens, reduced stroma ("back to back" aspect). Often, it associates intestinal metaplasia in neighboring mucosa. Depending on glandular architecture, cellular pleomorphism and mucosecretion, adenocarcinoma may present 3 degrees of differentiation: well, moderate and poorly differentiated. Diffuse type adenocarcinoma (mucinous, colloid, linitis plastica, leather-bottle stomach) Tumor cells are discohesive and secrete mucus which is delivered in the interstitium producing large pools of mucus/colloid (optically "empty" spaces). It is poorly differentiated. If the mucus remains inside the tumor cell, it pushes the nucleus to the periphery- "signet-ring cell".
- Around 5% of gastric malignancies are lymphomas (MALTomas, or MALT lymphoma).[26]
- Carcinoid and stromal tumors may also occur.
Staging
If cancer cells are found in the tissue sample, the next step is to stage, or find out the extent of the disease. Various tests determine whether the cancer has spread and, if so, what parts of the body are affected. Because stomach cancer can spread to the liver, the pancreas, and other organs near the stomach as well as to the lungs, the doctor may order a CT scan, a PET scan, an endoscopic ultrasound exam, or other tests to check these areas. Blood tests for tumor markers, such as carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) may be ordered, as their levels correlate to extent of metastasis, especially to the liver, and the cure rate.
Staging may not be complete until after surgery. The surgeon removes nearby lymph nodes and possibly samples of tissue from other areas in the abdomen for examination by a pathologist.
The clinical stages of stomach cancer are:[27][28]
- Stage 0. Limited to the inner lining of the stomach. Treatable by endoscopic mucosal resection when found very early (in routine screenings); otherwise by gastrectomy and lymphadenectomy without need for chemotherapy or radiation.
- Stage I. Penetration to the second or third layers of the stomach (Stage 1A) or to the second layer and nearby lymph nodes (Stage 1B). Stage 1A is treated by surgery, including removal of the omentum. Stage 1B may be treated with chemotherapy (5-fluorouracil) and radiation therapy.
- Stage II. Penetration to the second layer and more distant lymph nodes, or the third layer and only nearby lymph nodes, or all four layers but not the lymph nodes. Treated as for Stage I, sometimes with additional neoadjuvant chemotherapy.
- Stage III. Penetration to the third layer and more distant lymph nodes, or penetration to the fourth layer and either nearby tissues or nearby or more distant lymph nodes. Treated as for Stage II; a cure is still possible in some cases.
- Stage IV. Cancer has spread to nearby tissues and more distant lymph nodes, or has metastatized to other organs. A cure is very rarely possible at this stage. Some other techniques to prolong life or improve symptoms are used, including laser treatment, surgery, and/or stents to keep the digestive tract open, and chemotherapy by drugs such as 5-fluorouracil, cisplatin, epirubicin, etoposide, docetaxel, oxaliplatin, capecitabine, or irinotecan.
The TNM staging system is also used.[29]
In a study of open-access endoscopy in Scotland, patients were diagnosed 7% in Stage I 17% in Stage II, and 28% in Stage III.[30] A Minnesota population was diagnosed 10% in Stage I, 13% in Stage II, and 18% in Stage III.[31] However in a high-risk population in the Valdivia Province of southern Chile, only 5% of patients were diagnosed in the first two stages and 10% in stage III.[32]
Management
As with any cancer, treatment is adapted to fit each person's individual needs and depends on the size, location, and extent of the tumor, the stage of the disease, and general health. Cancer of the stomach is difficult to cure unless it is found in an early stage (before it has begun to spread). Unfortunately, because early stomach cancer causes few symptoms, the disease is usually advanced when the diagnosis is made. Treatment for stomach cancer may include surgery, chemotherapy, and/or radiation therapy. New treatment approaches such as biological therapy and improved ways of using current methods are being studied in clinical trials.[citation needed] An antibody-drug conjugate IMGN242 is in phase II clinical trials.[33][34]
Surgery
Surgery is the most common treatment. The surgeon removes part or all of the stomach, as well as the surrounding lymph nodes, with the basic goal of removing all cancer and a margin of normal tissue. Depending on the extent of invasion and the location of the tumor, surgery may also include removal of part of the intestine or pancreas. Tumors in the lower part of the stomach may call for a Billroth I or Billroth II procedure.
Endoscopic mucosal resection (EMR)[35] is a treatment for early gastric cancer (tumor only involves the mucosa) that has been pioneered in Japan, but is also available in the United States at some centers. In this procedure, the tumor, together with the inner lining of stomach (mucosa), is removed from the wall of the stomach using an electrical wire loop through the endoscope. The advantage is that it is a much smaller operation than removing the stomach. Endoscopic submucosal dissection (ESD) is a similar technique pioneered in Japan, used to resect a large area of mucosa in one piece. If the pathologic examination of the resected specimen shows incomplete resection or deep invasion by tumor, the patient would need a formal stomach resection.
Surgical interventions are currently curative in less than 40% of cases, and, in cases of metastasis, may only be palliative.
Chemotherapy
The use of chemotherapy to treat stomach cancer has no firmly established standard of care. Unfortunately, stomach cancer has not been particularly sensitive to these drugs, and chemotherapy, if used, has usually served to palliatively reduce the size of the tumor, relieve symptoms of the disease and increase survival time. Some drugs used in stomach cancer treatment have included: 5-FU (fluorouracil) or its analog capecitabine, BCNU (carmustine), methyl-CCNU (Semustine), and doxorubicin (Adriamycin), as well as Mitomycin C, and more recently cisplatin and taxotere, often using drugs in various combinations. The relative benefits of these different drugs, alone and in combination, are unclear.[36] Clinical researchers have explored the benefits of giving chemotherapy before surgery to shrink the tumor, or as adjuvant therapy after surgery to destroy remaining cancer cells. Combination treatment with chemotherapy and radiation therapy has some activity in selected post surgical settings. For patients who have HER2 overexpressing metastatic gastric or gastroesophageal (GE) junction adenocarcinoma, who have not received prior treatment for their metastatic disease, the US Food and Drug Administration granted approval (2010 October) for trastuzumab (Herceptin, Genentech, Inc.) in combination with cisplatin and a fluoropyrimidine (capecitabine or 5-fluorouracil). This was based on an improvement of the median overall survival (OS) of 2.5 months[37] with trastuzumab plus chemotherapy treatment compared to chemotherapy alone (BO18255 ToGA trial). The combination of Herceptin with chemotherapy for treating metastatic gastric cancer was also sanctioned by the European regulatory authorities (2010 January). Doctors have also tested putting the anticancer drugs directly into the abdomen, often with warmed solutions of the medication (intraperitoneal hyperthermic chemoperfusion).[38]
Radiation
Radiation therapy (also called radiotherapy) is the use of high-energy rays to damage cancer cells and stop them from growing. When used, it is generally in combination with surgery and chemotherapy, or used only with chemotherapy in cases where the individual is unable to undergo surgery. Radiation therapy may be used to relieve pain or blockage by shrinking the tumor for palliation of incurable disease.
Multimodality therapy
While previous studies of multimodality therapy (combinations of surgery, chemotherapy and radiation therapy) gave mixed results, the Intergroup 0116 (SWOG 9008) study[39] showed a survival benefit to the combination of chemotherapy and radiation therapy in patients with nonmetastatic, completely resected gastric cancer. Patients were randomized after surgery to the standard group of observation alone, or the study arm of combination chemotherapy and radiation therapy. Those in the study arm receiving chemotherapy and radiation therapy survived on average 36 months; compared to 27 months with observation.
Epidemiology
Age-standardized death from stomach cancer per 100,000 inhabitants in 2004.[40]
|
no data
<3.5
3.5-8
8-12.5
12.5-17
17-21.5
21.5-26
|
26-30.5
30.5-35
35-40
40-45
45-50
>50
|
Stomach cancer is the fourth most common cancer worldwide with 930,000 cases diagnosed in 2002.[41] It is a disease with a high death rate (~800,000 per year) making it the second most common cause of cancer death worldwide after lung cancer.[1] It is more common in men and in developing countries.[41][42]
It represents roughly 2% (25,500 cases) of all new cancer cases yearly in the United States, but it is more common in other countries. It is the leading cancer type in Korea, with 20.8% of malignant neoplasms.
Metastasis occurs in 80-90% of individuals with stomach cancer, with a six month survival rate of 65% in those diagnosed in early stages and less than 15% of those diagnosed in late stages.
One in 50 patients of all ages who seek medical attention for burping and indigestion are diagnosed with stomach cancer.[43] Out of 10 million people in the Czech Republic, only 3 new cases of stomach cancer in people under 30 years of age in 1999 were diagnosed.[44] Other studies show that less than 5% of stomach cancers occur in people under 40 years of age with 81.1% of that 5% in the age-group of 30 to 39 and 18.9% in the age-group of 20 to 29.[45]
For Taiwan (statistic not shown on the above map), the mortality was 11.75 per 100,000 (1996).
In other animals
The stomach is a muscular organ of the gastrointestinal tract that holds food and begins the digestive process by secreting gastric juice. The most common cancers of the stomach are adenocarcinomas but other histological types have been reported. Signs vary but may include vomiting (especially if blood is present), weight loss, anemia, and lack of appetite. Bowel movements may be dark and tarry in nature. In order to determine whether cancer is present in the stomach, special X-rays and/or abdominal ultrasound may be performed. Gastroscopy, a test using an instrument called endoscope to examine the stomach, is a useful diagnostic tool that can also take samples of the suspected mass for histopathological analysis to confirm or rule out cancer. The most definitive method of cancer diagnosis is through open surgical biopsy.[46] Most stomach tumors are malignant with evidence of spread to lymph nodes or liver, making treatment difficult. Except for lymphoma, surgery is the most frequent treatment option for stomach cancers but it is associated with significant risks.
References
- ^ a b "Cancer (Fact sheet N°297)". World Health Organization. February 2009. http://www.who.int/mediacentre/factsheets/fs297/en/. Retrieved 2009-05-11.
- ^ Tumors of the GI Tract at Merck Manual of Diagnosis and Therapy Professional Edition
- ^ a b "What Are The Risk Factors For Stomach Cancer(Website)". American Cancer Society. http://www.cancer.org/docroot/cri/content/cri_2_4_2x_what_are_the_risk_factors_for_stomach_cancer_40.asp. Retrieved 2010-03-31. [dead link]
- ^ Buckland G, Agudo A, Lujan L, Jakszyn P, Bueno-De-Mesquita HB, Palli D, Boeing H, Carneiro F, Krogh V (2009). "Adherence to a Mediterranean diet and risk of gastric adenocarcinoma within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study". American Journal of Clinical Nutrition 91 (2): 381–90. DOI:10.3945/ajcn.2009.28209. PMID 20007304.
- ^ "Proceedings of the fourth Global Vaccine Research Forum". Initiative for Vaccine Research team of the Department of Immunization, Vaccines and Biologicals. WHO. April 2004. http://www.who.int/vaccine_research/documents/en/gvrf2003.pdf. Retrieved 2009-05-11. "Epidemiology of Helicobacter pylori and gastric cancer…"
- ^ Hatakeyama, M. & Higashi, H (2005). "Helicobacter pylori CagA: a new paradigm for bacterial carcinogenesis". Cancer Science 96: 835–843. DOI:10.1111/j.1349-7006.2005.00130.x. PMID 16367902.
- ^ Lee H-J, Yang H-K, Ahn Y-O (2002). "Gastric cancer in Korea". Gastric Cancer 5 (3): 177–82. DOI:10.1007/s101200200031. PMID 12378346.
- ^ Alonso-Amelot ME, Avendaño M (March 2002). "Human carcinogenesis and bracken fern: a review of the evidence". Current Medicinal Chemistry 9 (6): 675–86. PMID 11945131. http://www.benthamdirect.org/pages/content.php?CMC/2002/00000009/00000006/0004C.SGM.
- ^ Nomura A, Grove JS, Stemmermann GN, Severson RK (1990). "Cigarette smoking and stomach cancer.". Cancer Research 50 (21): 7084. PMID 2208177. http://cancerres.aacrjournals.org/cgi/pmidlookup?view=long&pmid=2208177.
- ^ Trédaniel J, Boffetta P, Buiatti E, Saracci R, Hirsch A (August 1997). "Tobacco smoking and gastric cancer: Review and meta-analysis". International Journal of Cancer 72 (4): 565–73. DOI:10.1002/(SICI)1097-0215(19970807)72:4<565::AID-IJC3>3.0.CO;2-O. PMID 9259392.
- ^ Shimazu T, Tsuji I, Inoue M, Wakai K, Nagata C, Mizoue T, Tanaka K, Tsugane SResearch Group for the Development and Evaluation of Cancer Prevention Strategies in Japan (2008). "Alcohol Drinking and Gastric Cancer Risk: An Evaluation Based on a Systematic Review of Epidemiologic Evidence among the Japanese Population". Japanese Journal of Clinical Oncology 38 (1): 8–25. DOI:10.1093/jjco/hym152. PMID 18258712.
- ^ Sung NY, Choi KS, Park EC, Park K, Lee SY, Lee AK, Choi IJ, Jung KW, Won YJ (2007). "Smoking, alcohol and gastric cancer risk in Korean men: the National Health Insurance Corporation Study". British Journal of Cancer 97 (5): 700–4. DOI:10.1038/sj.bjc.6603893. PMC 2360367. PMID 17637680. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2360367.
- ^ http://www.hmc.psu.edu/healthinfo/s/stomachcancer.htm
- ^ Chandanos, Evangelos (December 2007) (PDF). Estrogen in the development of esophageal and gastric adenocarcinoma (Doctoral thesis). Karolinska Institutet. ISBN 978-91-7357-370-2. http://diss.kib.ki.se/2007/978-91-7357-370-2/thesis.pdf.
- ^ Brooks-Wilson AR, Kaurah P, Suriano G, Leach S, Senz J, Grehan N, Butterfield YS, Jeyes J, Schinas J (2004). "Germline E-cadherin mutations in hereditary diffuse gastric cancer: assessment of 42 new families and review of genetic screening criteria". Journal of Medical Genetics 41 (7): 508–17. DOI:10.1136/jmg.2004.018275. PMC 1735838. PMID 15235021. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1735838.
- ^ Venturi S, Venturi A, Cimini D, Arduini C, Venturi M, Guidi A (1993). "A new hypothesis". European Journal of Cancer Prevention 2 (1): 17–23. DOI:10.1097/00008469-199301000-00004. PMID 8428171.
- ^ Venturi S, Venturi M (1999). "Iodide, thyroid and stomach carcinogenesis: evolutionary story of a primitive antioxidant?". European Journal of Endocrinology 140 (4): 371–2. DOI:10.1530/eje.0.1400371. PMID 10097259.
- ^ Venturi S, Donati FM, Venturi A, Venturi M, Grossi L, Guidi A (2000). "Role of iodine in evolution and carcinogenesis of thyroid, breast and stomach". Advances in clinical pathology : the official journal of Adriatic Society of Pathology 4 (1): 11–7. PMID 10936894.
- ^ Abnet CC, Fan J-H, Kamangar F, Sun X-D, Taylor PR, Ren J-S, Mark SD, Zhao P, Fraumeni JF (2006). "Self-reported goiter is associated with a significantly increased risk of gastric noncardia adenocarcinoma in a large population-based Chinese cohort". International Journal of Cancer 119 (6): 1508–10. DOI:10.1002/ijc.21993. PMID 16642482.
- ^ Behrouzian R, Aghdami N (2004). "Urinary iodine/creatinine ratio in patients with stomach cancer in Urmia, Islamic Republic of Iran". Eastern Mediterranean health 10 (6): 921–4. PMID 16335780.
- ^ Gulaboglu M, Yildiz L, Celebi F, Gul M, Peker K (2005). "Comparison of iodine contents in gastric cancer and surrounding normal tissues". Clinical Chemistry and Laboratory Medicine 43 (6): 581–4. DOI:10.1515/CCLM.2005.101. PMID 16006252.
- ^ Gołkowski F, Szybiński Z, Rachtan J, Sokołowski A, Buziak-Bereza M, Trofimiuk MłG, Hubalewska-Dydejczyk A, Przybylik-Mazurek E, Huszno B (2007). "Iodine prophylaxis—the protective factor against stomach cancer in iodine deficient areas". European Journal of Nutrition 46 (5): 251–6. DOI:10.1007/s00394-007-0657-8. PMID 17497074.
- ^ Inoue H, Kudo S-, Shiokawa A (2005). "Technology Insight: laser-scanning confocal microscopy and endocytoscopy for cellular observation of the gastrointestinal tract". Nature Clinical Practice Gastroenterology & Hepatology 2 (1): 31–7. DOI:10.1038/ncpgasthep0072. PMID 16265098.
- ^ Pentenero M, Carrozzo M, Pagano M, Gandolfo S (2004). "Oral acanthosis nigricans, tripe palms and sign of leser-trelat in a patient with gastric adenocarcinoma". International Journal of Dermatology 43 (7): 530–2. DOI:10.1111/j.1365-4632.2004.02159.x. PMID 15230897.
- ^ Kumar; et al. (2010). Pathologic Basis of Disease (8th ed.). Saunders Elsevier. p. 784. ISBN 978-1-4160-3121-5.
- ^ Kumar 2010, p. 786
- ^ "Detailed Guide: Stomach Cancer Treatment Choices by Type and Stage of Stomach Cancer". American Cancer Society. 2009-11-03. http://www.cancer.org/docroot/cri/content/cri_2_4_4x_treatment_choices_by_type_and_stage_of_stomach_cancer_40.asp.
- ^ Guy Slowik (2009-10). "What Are The Stages Of Stomach Cancer?". ehealthmd.com. http://www.ehealthmd.com/library/stomachcancer/STC_stages.html.
- ^ "Detailed Guide: Stomach Cancer: How Is Stomach Cancer Staged?". American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_stomach_cancer_staged_40.asp?sitearea=.
- ^ Paterson HM, McCole D, Auld CD (2006). "Impact of open-access endoscopy on detection of early oesophageal and gastric cancer 1994–2003: population-based study". Endoscopy 38 (5): 503–7. DOI:10.1055/s-2006-925124. PMID 16767587.
- ^ Crane SJ, Locke GR, Harmsen WS, Zinsmeister AR, Romero Y, Talley NJ (2008). "Survival Trends in Patients With Gastric and Esophageal Adenocarcinomas: A Population-Based Study". Mayo Clinic Proceedings 83 (10): 1087–1094. DOI:10.4065/83.10.1087. PMC 2597541. PMID 18828967. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2597541.
- ^ Heise K, Bertran E, Andia ME, Ferreccio C (2009). "Incidence and survival of stomach cancer in a high-risk population of Chile". World Journal of Gastroenterology 15 (15): 1854–1862. DOI:10.3748/wjg.15.1854. PMC 2670413. PMID 19370783. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2670413.
- ^ http://pharmtech.findpharma.com/pharmtech/Ingredients+Insider/Antibody-Drug-Conjugates-A-Marriage-of-Biologics-a/ArticleStandard/Article/detail/522139
- ^ Goff LW, Papadopoulos K, Posey JA, Phan AT, et al. (2009). "A phase II study of IMGN242 (huC242-DM4) in patients with CanAg-positive gastric or gastroesophageal (GE) junction cancer". J Clin Oncol 27 (Suppl). http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=65&abstractID=33509.
- ^ Soetikno R, Kaltenbach T, Yeh R, Gotoda T (2005). "Endoscopic Mucosal Resection for Early Cancers of the Upper Gastrointestinal Tract". Journal of Clinical Oncology 23 (20): 4490–8. DOI:10.1200/JCO.2005.19.935. PMID 16002839.
- ^ Scartozzi M, Galizia E, Verdecchia L, Berardi R, Antognoli S, Chiorrini S, Cascinu S (2007). "Chemotherapy for advanced gastric cancer: across the years for a standard of care". Expert Opinion on Pharmacotherapy 8 (6): 797–808. DOI:10.1517/14656566.8.6.797. PMID 17425475.
- ^ Bang YJ, Van Cutsem E, Feyereislova A, et al. (August 2010). "Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial". Lancet 376 (9742): 687–97. DOI:10.1016/S0140-6736(10)61121-X. PMID 20728210.
- ^ "Bogota hospital offers hope to patients with advanced abdominal cancers". Colombia Reports. 16 March 2011. http://colombiareports.com/colombia-news/news/14923-bogota-hospital-offers-hope-to-abdominal-cancer-patients.html. Discussion of use of intraperoneal hyperthermic chemotherapy [HIPEC]. Accessed 10 April 2011.
- ^ MacDonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, Haller DG, Ajani JA, Gunderson LL (2001). "Chemoradiotherapy after Surgery Compared with Surgery Alone for Adenocarcinoma of the Stomach or Gastroesophageal Junction". New England Journal of Medicine 345 (10): 725–30. DOI:10.1056/NEJMoa010187. PMID 11547741.
- ^ "WHO Disease and injury country estimates". World Health Organization. 2009. http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html. Retrieved Nov. 11, 2009.
- ^ a b Parkin DM, Bray F, Ferlay J, Pisani P (2005). "Global Cancer Statistics, 2002". CA: A Cancer Journal for Clinicians 55 (2): 74–108. DOI:10.3322/canjclin.55.2.74. PMID 15761078.
- ^ "Are the number of cancer cases increasing or decreasing in the world?". WHO Online Q&A. WHO. 1 April 2008. http://www.who.int/features/qa/15/en/index.html. Retrieved 2009-05-11.
- ^ "Stomach cancer symptoms: Cancer Research UK". CancerHelp UK. 2007-06-15. http://www.cancerhelp.org.uk/help/default.asp?page=3897. Retrieved 2009-05-11.
- ^ Simsa J, Leffler J, Hoch J, Linke Z, Pádr R (2004). "Gastric cancer in young patients—is there any hope for them?" (PDF). Acta Chirurgica Belgica 104 (6): 673–6. PMID 15663273. http://www.belsurg.org/imgupload/RBSS/simsa.pdf. [dead link]
- ^ "Gastric Cancer in Young Adults". Revista Brasileira de Cancerologia 46 (3). Jul 2000. http://www.inca.gov.br/rbc/n_46/v03/english/article6.html.
- ^ Withrow SJ, MacEwen EG, ed. (2001). Small Animal Clinical Oncology (3rd ed.). W.B. Saunders Company.
External links
| Wikimedia Commons has media related to: Stomach cancer |
- National Cancer Institute Gastric cancer treatment guidelines
- GeneReview/NIH/UW entry on Hereditary Diffuse Gastric Cancer
- Gastric Cancer Surgery
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- 1. 胃癌の臨床的特徴、診断、および病期分類 clinical features diagnosis and staging of gastric cancer
- 2. 早期胃癌：治療、自然経過、および予後 early gastric cancer treatment natural history and prognosis
- 3. 胃癌の危険因子 risk factors for gastric cancer
- 4. 胃癌の補助化学療法および術前補助化学療法 adjuvant and neoadjuvant treatment of gastric cancer
- 5. 限局進行性で切除不能の転移性食道癌および胃癌に対する全身療法 systemic therapy for locally advanced unresectable and metastatic esophageal and gastric cancer
English Journal
- Glypican-3 as a potential differential diagnosis marker for hepatocellular carcinoma: a tissue microarray-based study.
- Zhang L, Liu H, Sun L, Li N, Ding H, Zheng J.SourceDepartment of Pathology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China.
- Acta histochemica.Acta Histochem.2012 Oct;114(6):547-52. Epub 2011 Nov 26.
- The differential diagnosis between hepatocellular carcinoma (HCC) and benign hepatic lesions is still difficult and new biochemical markers for HCC are required. The aim of this study was to assess the differential diagnostic value of glypican-3 (GPC3) immunostaining in HCC patients. 147 cases of su
- PMID 22119409
- Staging and outcome depending on surgical treatment in adenocarcinomas of the oesophagogastric junction.
- Reeh M, Mina S, Bockhorn M, Kutup A, Nentwich MF, Marx A, Sauter G, Rösch T, Izbicki JR, Bogoevski D.SourceDepartment of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany. mreeh@uke.de.
- The British journal of surgery.Br J Surg.2012 Oct;99(10):1406-14. doi: 10.1002/bjs.8884.
- BACKGROUND: Owing to controversial staging and classification of adenocarcinoma of the oesophago-gastric junction (AOG) before surgery, the choice of appropriate surgical approach remains problematic. In a retrospective study, preoperative staging of AOG and the impact of preoperative misclassificat
- PMID 22961520
Japanese Journal
- 胃肝様腺癌の悪性度と転移能
- 佐藤 英之,上野 義之,河田 純男,本山 悌一
- 山形大学紀要. 医学 : 山形医学 30(2), 51-65, 2012-08-15
- 【目的】これまで明確な証拠に乏しかった胃肝様腺癌の悪性度について、その実態とそれに関わる因子を明らかにすることを目的とする。【材料と方法】臨床病理学的解析のために外科的に切除した胃肝様腺癌18例を材料とし、対照として低分化充実型腺癌31例、管状腺癌16例を用いた。実験的に浸潤・転移能を解析するために胃癌由来の肝様腺癌細胞株、低分化充実型腺癌細胞株、管状腺癌細胞株それぞれ1株を材料とし、細胞接着性試 …
- NAID 110009445796
- Expression of the c-Met Proto-Oncogene and Integrin α5β1 in Human Gastric Cardia Adenocarcinoma
- CHI Fusheng,FU Da,ZHANG Xiaoping [他]
- Bioscience, Biotechnology, and Biochemistry 76(8), 1471-1476, 2012-08
- NAID 40019400125
- Adenocarcinoma in the jejunal pouch after proximal gastrectomy for early stage upper gastric cancer : report of a case
- KUROKAWA Takanori,KANAI Motoshi,KANEKO Yukihiro,TAKAHASHI Hiroshi,MOTOHARA Toshiji
- Surgery today : the Japanese journal of surgery 42(6), 605-609, 2012-06-01
- NAID 10030622299
Related Links
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- Cancer Therapy Vol 5, page 877 877 Cancer Therapy Vol 5, 877-894, 2007 Gastric adenocarcinoma: epidemiology, pathology and pathogenesis Review Article Stacy Carl-McGrath1,*, Matthias Ebert2, Christoph R cken1 1Institut f r ...
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★リンクテーブル★
| リンク元 | 「胃腺腫」「胃腺癌」「gastric adenoma」 |
| 関連記事 | 「gastric」 |
「胃腺腫」
「胃腺癌」
「gastric adenoma」
「gastric」
- adj.
- 胃の