Gastric cancer Flashcards
True or false: gastric cancer is twice as common in men than in women
True
What are 4 risk factors for gastric cancer?
1) H. pylori infection
2) tobacco smoking
3) high salt diet
4) genetic abnormalities
Explain how H. pylori infection can cause gastric cancer:
it can cause gastritis which can promote metaplasia
Name 2 tumour suppressor genes that often lose their heterozygosity in gastric cancer?
1) p53
2) APC
What are the two types of gastric cancer?
1) intestinal
2) diffuse
A mutation of what cell adhesion molecule is seen in diffuse gastric cancers?
E-cadherin
Describe the differentiation of intestinal (type 1) gastric cancers:
well-differentiated cancers
Describe the differentiation of diffuse (type 2) gastric cancers:
poorly differentiated cancers
Which type of gastric cancer tends to infiltrate the gastric wall?
Diffuse
Where do intestinal gastric cancers mainly occur?
distal stomach
Where do diffuse gastric cancers mainly occur?
anywhere in stomach but especially in the cardia
Which type of gastric cancer has the worse prognosis?
Diffuse
Describe the appearance of an intestinal gastric cancer:
ulcerating lesion with rolled edges
What type of gastric cancer is associated with H. pylori and chronic gastritis?
intestinal
Give 3 symptoms associated with gastric cancer:
1) epigastric pain
2) weight loss and anorexia
3) nausea
True or false: gastric cancer is mostly asymptomatic and so diagnosis occurs at an advanced stage of disease
True
What is linitus plastica?
where a widely spreading submucosal gastric cancer causes diffuse thickening and rigidity of the stomach
What specific symptom may a patient present with if the tumour is in the pylorus?
Vomiting
What specific symptom may a patient present with if the gastric tumour is in the fundus?
dysphagia (A condition with difficulty in swallowing food or liquid. This may interfere in a person’s ability to eat and drink.)
What lymph node may be palpable in gastric cancer?
Virchow’s node (supraclavicular fossa, left side)
What abdominal palpation sign is associated with gastric cancer?
palpable epigastric mass with abdominal tenderness
What is the main diagnostic investigation for gastric cancer?
gastroscopy and biopsy
How many biopsies should be taken during a gastroscopy for gastric cancer?
8-10
What staging system is used in gastric cancer?
TNM (tumour, node, metastasis)
Give two investigations used to help stage a gastric cancer:
1) CT chest and abdomen (check for gastric wall thickening, lymphadenopathy and liver and lung metastasis)
2) endoscopic ultrasound (investigating depth of penetration through the gastric wall)
What is the most common form of management for gastric cancer?
surgery often with chemotherapy
What are gastrointestinal stromal tumours?
a subset of GI mesenchymal tumours including leiomyomas and leiomyoblastomas
Name two treatments for gastrointestinal stromal tumours:
1) surgery
2) imatinib (used in metastasis)
What is the mechanism of imatinib?
tyrosine kinase inhibitor
