Gastric Malignancies
Gastric Malignancies
Gastric Malignancies
MALIGNANCIES
DEFINITION
Previous surgery is implicated as a risk factor. The rationale is that surgery alters the
normal pH of the stomach, which may in turn lead to metaplastic and dysplastic
changes in luminal cells.
Retrospective studies demonstrate that a small percentage of patients who undergo
gastric polyp removal have evidence of invasive carcinoma within the polyp. This
discovery has led some researchers to conclude that polyps might represent
premalignant conditions.
GENETIC FACTORS
Some 10% of stomach cancer cases are familial in origin. Genetic factors involved in
gastric cancer remain poorly understood, though specific mutations have been identified in
a subset of gastric cancer patients. For example, germline truncating mutations of the E-
cadherin gene (CDH1) are detected in 50% of diffuse-type gastric cancers, and families that
harbor these mutations have an autosomal dominant pattern of inheritance with a very high
penetrance.
Other hereditary syndromes with a predisposition for stomach cancer include the following:
•Hereditary nonpolyposis colorectal cancer
•Li-Fraumeni syndrome
•Familial adenomatous polyposis
•Peutz-Jeghers syndrome
BISPHOSPHONATES