Gastric Carcinoma Flashcards
What is the most common type of gastric carcinoma?
Adenocarcinoma
What does adenocarcinoma affect?
Mucus secreting cells of gastric pits
What mutation is associated with gastric carcinoma?
P53 gene
What is the main RF for gastric carcinoma?
Persistent H. pylori infection
What does a persistent H. Pylori infection lead to?
Destruction of gastric glands
What are other possible risk factors of gastric carcinoma?
Smoking and Alcohol
Diet high in nitrates
How does gastric carcinoma present?
Dyspepsia
Weight loss
Nausea/ vomiting
What are red flag symptoms of gastric carcinoma?
Dysphasia
Iron deficiency anaemia
Epigastric mass
How is gastric carcinoma diagnosed?
Oesophago-gastro-duodenoscopy with biopsy
What would you see on an endoscopy of someone with gastric carcinoma?
Signet ring cells
What would you see on an endoscopy of someone with gastric carcinoma?
Signet ring cells
What is used for staging gastric carcinoma?
CT chest, abdomen and pelvis
What is the surgical management of gastric carcinoma?
Gastrectomy (endoscopic mucosal resection)
What is the medical management of gastric carcinoma?
Combination Chemotherapy (cisplatin)
Where does gastric carcinoma metastasise to?
Transcoelomic- Ovaries
Local and lymphatic spread
What is the term for cancer that spreads to the ovaries?
Krukenberg tumour
What is the prognosis of gastric carcinoma?
20%
How does a typical patient present?
Indigestion which isn’t improved with PPI’s
What 2 lymph nodes does gastric cancer spread to?
left supraclavicular lymph node (Virchow’s node)
periumbilical nodule (Sister Mary Joseph’s node)
What does an increased number of signet ring cells indicate?
A worse prognosis
What are the main RF for gastric carcinoma?
Smoking
Pernicious anaemia
H. pylori infection
High alcohol intake (> 6 units per day)
Dietary nitrosamine
When would you refer someone urgently for gastric carcinoma (within 2 weeks)?
Dysphagia (at any age)
Aged 55 and over with weight loss AND
–Upper abdominal pain OR reflux OR dyspepsia
–Upper abdominal mass consistent with stomach cancer