Gastric Cancer

Question 1

Cause of hereditary diffuse gastric cancer

Answer 1

think signet ring cancer
CDH1; AD

Question 2

Risks associated to HDGC

Answer 2

Gastric Cancer men 67-70%, women 56-83%
lobular breast cancer: 42%

Question 3

What kind of gene is CDH1

Answer 3

tumor suppressor

Question 4

NCCN Testing criteria for HDGC (Family)

Answer 4

2 or more cases of gastric cancer in family with at least one diffuse gastric cancer
or
1 or more cases of diffuse gastric cancer and 1 case of lobular breast cancer under 70 in different family members
or
2 or more cases of lobular breast cancer in family members

Question 5

NCCN Testing criteria for HDGC (Individual)

Answer 5

diffuse gastric cancer under 50
DGC at any age in individuals of Maori ethnicity
DGC in individuals with personal or family history of cleft lip or pallate
history of DGC and lobular breast cancer under 70
gastric in situ ring cell in individual under 50

Question 6

CDH1 recommendations

Answer 6

prophylactic total gastrectomy between 18 and 40

Question 7

HDGC endoscopy

Answer 7

detects 40-61% of signet ring cancers
28-30 random biopsies
not appropriate for those with FHX

Question 8

Counseling issues in HDGC

Answer 8

Gastrectomy is controversial
variable prevention/ high prentrance
age of patients
screening effectiveness