Gastric Cancer Flashcards
What are the four regions of the stomach?
Cardia, Fundus, Body, Pylorus
What are the layers of the gastric wall?
The stomach wall consists of four main layers: mucosa (innermost), submucosa, muscularis externa (with three muscle layers), and serosa (outermost)
What types of gastric cancer are there?
- Adenocarcinoma (Columnar glandular epithelium)
- Lymphoma (Lymphocytes)
- Carcinoid Tumour (G-cells of stomach)
- Leiomyosarcoma (smooth muscle cells)
What is the most common subtype of gastric cancer?
Intestinal adenocarcinoma
What are common risk factors for gastric cancer?
- Family history
- Smoking
- Alcohol
- Obesity
- Age
- Male gender
Which specific risk factors are associated with intestinal type adenocarcinoma?
- Male
- H. pylori infection
- Type A blood
- Diet high in nitrates, salt, smoked/pickled foods
- Autoimmune gastritis
- ** Pernicious anemia**
- Achlorhydria
- Lynch syndrome
- Ethnicity (Japan, China)
What protective factors can reduce the risk of gastric cancer?
- Fruit and vegetables
- Fibre
- Folate
What symptoms may present initially in gastric cancer?
- Malaise
- Loss of appetite
- Dyspepsia
What symptoms may occur as gastric cancer progresses?
- Epigastric pain
- Nausea
- Vomiting
- Weight loss
- Anorexia
- With ulcer/bleeds: haemoatemesis/malena
What are some signs associated with gastric cancer?
- IDA (iron deficiency anemia)
- Acanthosis nigricans
- Enlarged Virchow’s node
- Sister Mary Joseph sign
- Palpable mass
- Melena on DRE
- Leser-Trelat sign
What is the primary method for diagnosing gastric cancer?
OGD Endoscopy with biopsy
2 week wait referal pathway
What are the secondary methods for staging gastric cancer?
- CT TAP
- X-ray with Barium contrast
- Endoscopic ultrasound
- PET scan
What are the tumor markers associated with gastric cancer?
- CEA
- CA19-9
What is the treatment for initial stage gastric cancer without metastasis?
- Surgery (oesophagogastrectomy, total gastrectomy, sub-total gastrectomy)
- Lymph node dissection
What types of surgery are used in advanced gastric cancer?
Palliative surgery
What chemotherapy agents are used for HER2 positive gastric cancers?
Herceptin
What are common complications associated with gastric cancer?
- **Metastasis **(peritoneum, liver, ovary, lymph nodes)
- Gastrectomy-related issues (Vitamin B12 deficiency, IDA, bacterial overgrowth, dumping syndrome)
- Paraneoplastic syndromes (Leser-Trelat sign, Polyarteritis nodosa, Trousseau syndrome, Pseudoachalasia syndrome)
What is the significance of H. pylori in gastric cancer?
Triggers inflammation of the mucosa, atrophy, and dysplasia
What is the definition of Leser-Trelat sign?
Sudden onset of seborrhoeic keratosis
What is the role of CDH1 mutation in diffuse adenocarcinoma?
Causes increased cell migration and invasion
What is Acanthosis Nigricans?
Darkening of skin at axilla and skin folds
Fill in the blank: The stomach’s epithelial layer includes _______.
H+, enzymes
