Early gastric cancer

Lan-Kai-Wei etal. (1991). The clinical and laboratory studies of superoxide dismutase activity in the human whole blood with early gastric cancer. Free Rad. Res. Commun. 12-13, 759-760. 

Chan, M. W., Chu, E. S., To, K. F., and Leung, W. K. (2004) Quantitative detection of methylated SOCS-1, a tumor suppressor gene, by a modified protocol of quantitative real time methylation-specific PCR using SYBR green and its use in early gastric cancer detection. Biotechnol. Lett. 26, 1289-1293. 

Photodynamic therapy has also been applied to the treatment of early gastric cancer. Photodynamic therapy appears to be superior to other modalities including thermal laser for this indication. This is particularly true for lesions with a depth of invasion estimated to be limited to the submucosa and where the margins of the lesion are unclear [38]. 

Y. Ito, A. Kameya, T. Kano, S. Kobayashi, T. Kasugai, S. Hotta (1988). Indications and limitations of laser treatment for early gastric cancer and palliative treatments for malignant obstruction of the esophagus and stomach. Gan to Kagaku Ryoho [Jpn. J. Cancer Chemother.], 15(4 Pt 2-3), 1435-1439. 

S. Mimura, Y. Ito, T. Nagayo, et al. (1996). Cooperative clinical trial of photodynamic therapy with photofrin II and excimer dye laser for early gastric cancer. Lasers Surgery Med., 19(2), 168-172. 

Ml. Maehara, Y., Oshiro, T., Endo, K., Baba, H., Oda, S., Ichiyoshi, Y., et al.. Clinical significance of occult micrometastasis lymph nodes from patients with early gastric cancer who died of recurrence. Surgery 119, 397 02 (1996). 

Endoscopic mucosal resection is currently being used in Japan for cases of early gastric cancer of the intestinal type. In this method, saline is injected into the submucosa to lift the tumor away from the underlying layers, then ensnared and removed with electrocautery. This method can be attempted for selected early gastric cancers ... 

Montei, A., Graziana, L., Pesaresi, A. et al.. Radiological diagnosis of early gastric cancer by routine double-contrast examination, Gastrointest Radiol, 7,205,1982. 

Studies on the association of H. pylori with gastric cancer start with a report in 1991, which described the higher seram titer for H. pylori in patients who developed gastric adenocarcinoma in a prospective study. There are basically two kinds of gastric adenocarcinoma well-differentiated (intestinal type) and poorly differentiated (diffuse type). In a Japanese study that focused on early gastric cancer, the odds for serum positivity were higher in well-differentiated adenocarcinoma than in poorly differentiated adenocarcinoma. 

M. Tada, A. Murakami, M. Karita, H. Yanai, K. Okita, Endoscopic resection of early gastric cancer. Endoscopy 25 (1993) 445-450. 

It is not always easy, and often rather difficult, to detect early gastric cancer by means of routine ultrasonographic screening, because both the wall thickening and alteration of wall stratification are too subtle to be detected with transabdominal ultrasound. In this respect, ingestion of water is useful to obtain a clear image of such subde changes. 

Fig. 16.4. a Sonographic image of an early (submucosal invasion) gastric cancer. Narrowing of the submucosal layer is demonstrated. b Endoscopic sonography of an early gastric cancer (submucosal invasion). There is narrowing of the submucosal layer beneath the tumor... 

The depth of cancer for an early gastric cancer is decided by assessment of alteration of wall stratification. The extension of an advanced gastric cancer is decided by careful evaluation of the tumor margin. When the outer margin of the tumor is smooth and a... 

Table 16.4. Bormann classification of Early Gastric Cancer...

The detection of early gastric cancer (EGG) on axial CT is generally low With the use of 3D CT, not only is the detection rate of EGC over 90%, but it is also possible to obtain accurate categorization accordingto the Borrmann classification (Table 16.5) (Figs. 16.4-16.6). 

Fig. 2.12a,b. Early Gastric Cancer. Double Contrast barium study (a) shows a flat ulcerated lesion on a background of normal mucosa. The folds are distortedandtruncated at the level of the flat lesion. Histopathology of the resection specimen (b) confirmed an early gastric adenocarcinoma... 

The Japanese Society of Gastroenterology has defined the main endoscopic types of early gastric cancers - that is to say a cancer whose invasion is limited to the mucosa and submucosa. In these cases the dysplastic area is strictly limited to the mucous membrane and its total thickness should be less than twice that of the surrounding mucosa. As noted above Type I is a polypoid cancer and type III an ulcerated one. Type II is subdivided into three. It may be slightly elevated (type Ila), true flat (type lib), or depressed (type lie) (Fig. 3.37). Combinations of these are common. 

Early gastric cancer is defined as gastric carcinoma that is limited to the mucosa and submucosa with or without associated lymphadenopathy (Gore et al. 1997). At double-contrast barium meal early gastric cancer appears as an elevated poly-... 

Gastric cancer remains a deadly disease, with overall 5-year survival rates of <20%. Early gastric cancers, however, are curable lesions with 5-year survival rates of more than 90%. The peak incidence is between 50 and 70 years of age (Moore... 

In early gastric cancers, malignant invasion is limited to the mucosa or submucosa, regardless of the presence of lymph node metastases (Maruyama and Baba 1994). Early cancers are classified into three types (Davis 1993 Fig. 6.2.1), and type I lesions can be better detected than type-II and type-III lesions (Fig. 6.2.2). 

Fig. 6.2.1. Types of early gastric cancer. (Modified from Davis 1993)...

Maehara Y, Orita H, Okuyama T et al (1992) Predictors of lymph node metastasis in early gastric cancer. Br J Surg 79 245-247... 

Yanai H, Matsumoto Y, Harada T et al (1997) Endoscopic ultrasonography and endoscopy for staging depth of invasion in early gastric cancer a pilot study. Gastrointest Endosc 46 212-216... 

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