7.1 Upper GIT Cancers Flashcards
What are the risk factors for oesophageal SCC?
Low SES Alcohol, smoking Obesity, reflux and Barrett's Thermal injury (radiation) Toxins Dietary deficiencies Genetics
What is the typical presentation of oesophageal SCC?
dysphagia, odynophagia, GI bleeding from ulcers, weight loss (from change in diet)
What is the main cause of oesophageal adenocarcinoma and where does it normally occur?
Barrett’s at the gastro-oesophageal junction
What is the treatment for adenocarcinoma and SCC of the oesophagus?
Surgery, SCC radiosensitive, chemo for adenocarcinoma
what is the most common cause of stomach cancer?
Chronic gastritis
What are the risk factors for gastric carcinoma?
H. pylori infection Autoimmune gastritis Diet Tobacco Radiation Genetics (susceptibility to h.pylori, familial cancer, HNPCC)
What does a cytokeratin stain in the stomach show?
Will highlight individual epithelial cells which should not be present in the stomach - gastric carcinoma
What indicates ACC in the stomach?
Signet rings which contain vacuoles - so poorly differentiated that it cant make glands anymore but can produce mucin
What is the treatment for gastric cancer?
Surgery is the main one
Chemo in those which are Herpcidin mutations
What is the main type of cancer in the small intestine?
Adenocarcinoma primarily at the ampulla
What is the most common mesenchymal tumour of the GI tract?
Gastrointestinal stromal tumour
What mutations do most Gastrointestinal stromal tumours have, what does this cause and what drug targets them?
KIT mutation (some have PDGFR mutation) Causes switches on cell proliferation and survival pathways Treatment is Imitinib
In what cells do GIST arise?
interstitial cells of Cajal (pacemaker cells)
Who normally gets GIST?
40-60 year olds - slightly more males
What histology will you see with GIST?
Spindle cells
Epithelioid (likely to be PDGFR)
CD117 (KIT)
