GASTRIC CARCINOMA Student: Ybyrai A. Faculty: GM Group: 30 -01 Almaty, 2014
GASTRIC CARCINOMA
MALIGNANT GASTRIC NEOPLASM * Adenocarcinoma (90%- 95% of all malignant tumors) * Lymphoma (NHL, MALT) * GIST (various sarcomas) * Neuroendocrine tumors (Carcinoid tumors)
GASTRIC CARCINOMA INCIDENCE
GASTRIC CARCINOMA RISK FACTORS Diet - Nitrites , smokers, lack of fresh vegetables Host factors: - Chronic atrophic gastritis (ACHLORHYDRIA) - H. pylori infection - a cofactor - Prior partial gastrectomy - Gastric adenomas Genetic factors - probably minor - Blood group A - Family history - Race
GASTRIC CARCINOMA CLASSIFICATION Depth of invasion EARLY GASTRIC CA - mucosa & submucosa ADVANCED GASTRIC CA - into or through muscularis propria Macroscopic growth pattern Expanding Infiltrative Histologic - "linitis plastica" subtype Intestinal Diffuse (gastric); poorly differentiated; "signet ring" cells
GASTRIC CANCER METASTASES Regional nodes (supraclavicular = Virchow's node) Liver, lungs Peritoneal surface Ovary - "Krukenberg tumor" (signet ring cell type)
GASTRIC CANCER Is presumed that Gastric Cancer develops as multistep process in which multiple factors: - genetic ( inherited and acquired) - environmental insults are acting over a period of time.
PRECURSORS OF GASTRIC CANCER Adenomatous polyps Chronic atrophic gastritis Pernicious gastritis Menetries’s disease Previous gastric surgery for noncancerous conditions
GASTRIC CANCER “ Its primary concern is which the problem of surgical cure of the all to frequent carcinoma of the stomach against which all internal therapy was proven ineffective” Prof. Th. Billroth (1881 –open letter to Vienna Medical Weekly)
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