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NCI CANCERLIT^® Search: Diagnosis-Histopathology-Pathogenesis of Gastric Cancer - September 2002

Imprima English

National Cancer Institute^®
Ultima Vez Modificado: 1 de septiembre del 2002

[Primary gastric lymphoma]
[Helicobacter pylori adherent to MKN-45 cell]
[Role of echoendoscopy in the study of gastric diseases with fold thickening and in gastric lymphomas]
Lymph node metastases in gastric cancer: correlation between new and old UICC TNM classification.
Treatment of patients with gastric cancer and duodenal invasion.
Gastric epithelial dysplasia.
Estrogen receptor beta is expressed in human stomach adenocarcinoma.
Correlation of Helicobacter pylori and gastric carcinoma.
hMLH1 and hMSH2 mutations in families with familial clustering of gastric cancer and hereditary non-polyposis colorectal cancer.
Pathogenic complexity of gastric B-cell lymphoma.
Hyperplastic polyps of the stomach: associations with histologic patterns of gastritis and gastric atrophy.
Clinicopathological features of gastric mucosa-associated lymphoid tissue lymphoma: a comparison with diffuse large B-cell lymphoma without
[Populational research of gastric cancer in digestive symptomatic patients, from 1996 to 2000]
Active and passive smoking and the risk of stomach cancer, by subsite, in Canada.
Vascular endothelial growth factor-C expression predicts lymph node metastasis of human gastric carcinomas invading the submucosa.
Ectopic expression of guanylyl cyclase C in adenocarcinomas of the esophagus and stomach.
A prospective study of stomach cancer death in relation to green tea consumption in Japan.
A current view of gastric cancer in the US.
Cancer of the stomach. A patient care study by the American College of Surgeons.
Superantigens and autoantigens may be involved in the pathogenesis of gastric mucosa-associated lymphoid tissue lymphoma.
Occupation and risk of esophageal and gastric cardia adenocarcinoma.
Juvenile polyposis: massive gastric polyposis is more common in MADH4 mutation carriers than in BMPR1A mutation carriers.
Prognostic impact of lymphatic and/or blood vessel invasion in patients with node-negative advanced gastric cancer.
Detection of HCV RNA in gastric mucosa-associated lymphoid tissue by in situ hybridization: evidence of a new extrahepatic localization of HCV
Changes in pattern of immunoglobulin heavy chain gene rearrangement and MIB-1 staining before and after eradication of Helicobacter pylori in
Factors contributing to the development of gastric cancer due to Helicobacter pylori infection.
Regional differences in incidence of gastric and colonic cancer in the Maori of New Zealand.
Outcomes after emergency surgery for gastric perforation or severe bleeding in patients with gastric cancer.
Evidence of genetic progression in human gastric carcinomas with microsatellite instability.
Mutation of hMSH3 and hMSH6 mismatch repair genes in genetically unstable human colorectal and gastric carcinomas.
Characteristics of human gastric carcinoma cell lines with induced multidrug resistance.
RER phenotype and its associated mutations in familial gastric cancer.
Mutations at coding mononucleotide repeats in gastric cancer with the microsatellite mutator phenotype.
Microsatellite instability and K-ras mutations in gastric adenomas, with reference to associated gastric cancers.
Relationship between intratumor histological heterogeneity and genetic abnormalities in gastric carcinoma with microsatellite instability.
Analysis of the candidate target genes for mutation in microsatellite instability-positive cancers of the colorectum, stomach, and
Microsatellite instability in synchronous gastric carcinomas.
Microsatellite instability in double primary cancers of the colorectum and stomach.
Somatic mutations in the DNA damage-response genes ATR and CHK1 in sporadic stomach tumors with microsatellite instability.
Diagnostic laparoscopy, serum CA125, and peritoneal metastasis in gastric cancer.
Urinary tea polyphenols in relation to gastric and esophageal cancers: a prospective study of men in Shanghai, China.
Primary gastric B-cell lymphoma: results of a prospective multicenter study. The German-Austrian Gastrointestinal Lymphoma Study Group.
API2-MALT1 chimeric transcript is a predictive marker for the responsiveness of H. pylori eradication treatment in low-grade gastric
[Some light for the prognosis of gastric cancer]
[Influence of laparoscopic staging on therapy of stomach carcinoma]
[Gastric cancer invading the muscularis propia]
[Comparison of the histopathological findings among the biopsies of non-cancerous gastric mucosa of patients with gastric cancer and the
Lymph nodes in gastric B-cell lymphoma: pattern of involvement and early histological changes.
Clinical evaluation of pN-stage (TNM) in gastric cancer: an analysis of distribution of regional lymph nodes in node-positive patients.
The influence of interleukin-10 and interleukin-18 on interferon-gamma production by peritoneal exudate cells in patients with gastric
Gastric carcinoma: pathology findings in a multiethnic population.
Functional allelic loss detected at the protein level in archival human tumours using allele-specific E-cadherin monoclonal antibodies.
Prospective study of educational background and stomach cancer in Japan.
Evaluation of treatment for synchronous hepatic metastases from gastric cancer with special reference to long-term survivors.
Designing clinical trials on gastric lymphomas and reporting outcomes.
Role of interleukin-1alpha and type I interleukin-1 receptor in the growth activity and invasion of gastric carcinoma cells.
Distribution of vacA genotypes in Helicobacter pylori strains isolated from Brazilian adult patients with gastritis, duodenal ulcer or gastric
Preferential loss of Fhit expression in signet-ring cell and Krukenberg subtypes of gastric cancer.
[The prevalence of Helicobacter pylori infection in gastric cancer and gastric stump cancer]
Delays in the diagnosis of oesophagogastric cancer: a consecutive case series.
Delays in the diagnosis of oesophagogastric cancer: a consecutive case series. Commentary: Britain does better than Germany before patients
Expression of multiple cancer-testis antigen genes in gastrointestinal and breast carcinomas.
Malignant transformation of gastric hyperplastic polyps.
Cigarette smoking, use of other tobacco products and stomach cancer mortality in US adults: The Cancer Prevention Study II.
Comprehensive analysis of the gene expression profiles in human gastric cancer cell lines.
Heparanase: a key enzyme in invasion and metastasis of gastric carcinoma.
Distinct clinical features and outcomes of gastric cancers with microsatellite instability.
Transforming growth factor beta type II receptor expression in gastric cancer: evidence for two independent subgroups.
Epstein-Barr virus in gastric adenocarcinomas: association with ethnicity and CDKN2A promoter methylation.
CDH1 c-160a promotor polymorphism is not associated with risk of stomach cancer.
Mutant cell surface receptors as targets for individualized cancer diagnosis and therapy.
Loss of expression of tumor suppressor p16(INK4) protein in human primary gastric cancer is related to the grade of differentiation.
E-cadherin mutations and hereditary gastric cancer: prevention by resection?
Gastric cancer and H pylori.
A gene encoding human gastric signet ring cell carcinoma antigen recognized by HLA-A31-restricted cytotoxic T lymphocytes.

1
UI - 12181844
AU - Zvonkov EE; Pivnik AV; Lorie IuIu
TI - [Primary gastric lymphoma]
SO - Ter Arkh 2002;74(7):76-80

2
UI - 12187829
AU - Oda H
TI - [Helicobacter pylori adherent to MKN-45 cell]
SO - Hokkaido Igaku Zasshi 2002 Jul;77(4):333-40
AD - Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan.

3
UI - 11835869
AU - Roseau G
TI - [Role of echoendoscopy in the study of gastric diseases with fold thickening and in gastric lymphomas]
SO - Gastroenterol Hepatol 2002 Jan;25(1):19-25
AD - Service de Gastroenterologie, Hopital Cochin, Paris, France.

4
UI - 11890334
AU - Omejc M; Juvan R; Jelenc F; Repse S
TI - Lymph node metastases in gastric cancer: correlation between new and old UICC TNM classification.
SO - Int Surg 2001 Jan-Mar;86(1):14-9
AD - Department of Abdominal Surgery, University Medical Center, Ljubljana, Slovenia. mirko.omejc@mf.uni-lj.si
The 5th edition of TNM classification (1997) grades lymph node involvement in gastric cancer by the number of metastatic lymph nodes. Their prognostic significance as defined by the new (5th edn., 1997) and old (4th edn., 1987) TNM classification was evaluated and survival in pN categories between both versions was compared. It was demonstrated in our analysis that comparison of old and new TNM systems is possible. Categories pN1 and pN2 contain patients selected by different criteria in both versions of TNM classification but with similar survival probabilities. Anatomic location of lymph nodes as described in the 4th edn. and number of involved nodes in the 5th edn. of TNM classification have about the same prognostic value in categories pN1 and pN2. The advantage of the 5th edn. is the identification of a group of patients (pN3, >15 involved lymph nodes) with significantly poor prognosis, which, in our series, includes 15% of R0 resected patients with lymph node metastases.

5
UI - 11890346
AU - Ajisaka H; Fujita H; Kaji M; Maeda K; Yabushita K; Konishi K; Uchiyama
TI - A; Miwa A Treatment of patients with gastric cancer and duodenal invasion.
SO - Int Surg 2001 Jan-Mar;86(1):9-13
AD - Department of Surgery, Toyama Prefectural Central Hospital, Japan.
We retrospectively examined clinicopathologic features of gastric cancer with duodenal invasion to clarify the effect of surgical treatment that include pancreaticoduodenectomy (PD). Among 2504 patients with gastric cancer, 69 (2.8%) who had gastric cancer and duodenal invasion resected by surgical treatment were investigated. The mode of the duodenal invasion was grouped into three categories: mucosal type, submucosal type, and nodal type. Mucosal type is invasion of the duodenal mucosal layer, submucosal type is invasion of the submucosal layer or deeper, and nodal type is invasion from nodal metastatic lesions around the pancreatic head. The 5-year survival rates of curative PD and curative gastrectomy were 37.3% and 33.8%, respectively. Despite the incidence of adjacent tissue infiltration and significantly higher duodenal invasion average length in cases with PD than in cases with gastrectomy, there was no significant difference in the survival curves. However, the prognoses of the cases with nodal-type invasion were significantly poorer, and all these patients died within 2 years, regardless of whether curative PD had been performed. Curative PD improves the prognosis of cases with long duodenal invasion or pancreas infiltration except for nodal-type duodenal invasion.

6
UI - 11936263
AU - Misdraji J; Lauwers GY
TI - Gastric epithelial dysplasia.
SO - Semin Diagn Pathol 2002 Feb;19(1):20-30
AD - Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA. jmisdraji@partners.org
Gastric dysplasia is considered to be the penultimate stage of the gastric carcinogenesis sequence. Its clinical importance has been underscored since its association with gastric adenocarcinoma was established. High-grade dysplasia and to a lesser degree low-grade dysplasia are markers of increased cancer risk, although their natural histories are difficult to determine. There are many pitfalls in the diagnosis of gastric dysplasia. Its recognition and grading are subject to interobserver variability, particularly at the lower end of the histologic spectrum (negative v indefinite for dysplasia v low-grade dysplasia) when inflammation is present. Also, diagnostic criteria and grading schemes have evolved differently worldwide resulting in disagreement between pathologists. Against this background, the authors review contemporary issues related to gastric dysplasia, its definition, classification, grading, and natural history. We also discuss new classifications of gastric epithelial dysplasia designed to develop equivalence between grading schemes worldwide.

7
UI - 12073050
AU - Matsuyama S; Ohkura Y; Eguchi H; Kobayashi Y; Akagi K; Uchida K; Nakachi
TI - K; Gustafsson JA; Hayashi S Estrogen receptor beta is expressed in human stomach adenocarcinoma.
SO - J Cancer Res Clin Oncol 2002 Jun;128(6):319-24
AD - Department of Surgery, Saga Medical School, 5-1-1 Nabeshima, Saga-city, Saga 849-8501, Japan. smatsuya@ga3.so-net.ne.jp
PURPOSE: In stomach adenocarcinoma, the role of the hormonal receptor, estrogen receptor (ER), has been controversial. Recently, a new estrogen receptor, called estrogen receptor beta (ER beta), was found to be expressed in various tissues including normal gastrointestinal tract. In this paper, the expression of ER beta in stomach adenocarcinomas has been investigated for the first time, specifically in signet ring cell adenocarcinomas, together with surrounding non-cancerous tissues. METHODS: By immunohistochemistry the expression of ER alpha and beta was studied in 29 stomach adenocarcinomas, ten signet ring cell adenocarcinomas, and 19 other adenocarcinomas. Western blotting was performed to examine the immunohistochemical result. Statistical studies (Student's t test and chi(2)-test) explored the relation between the immunohistochemical result and clinicopathological characteristics. RESULTS: All 29 adenocarcinomas, including the signet ring cell ones, demonstrated clear ER beta nucleus staining. Lymphocytes, venous endothelial cells, smooth muscle, and non-cancerous stomach glands also showed strong ER beta staining, while no staining was observed in the immunohistochemistry of ER alpha. Western blotting showed equivalent ER beta protein levels in cancerous and non-cancerous tissues, which was consistent with the results of immunohistochemical staining. Among signet ring cell adenocarcinomas of the stomach, cytoplasm were stained in addition to nuclei, specifically in patients under the age of 40 years. CONCLUSIONS: Our results imply that the effects of estrogen in stomach cancer, as well as those in normal stomach, may be mediated by ER beta, and that the role of ER beta may differ by the subtype of stomach adenocarcinoma - specifically signet ring cell adenocarcinomas and other ones - although large scale samples are needed to confirm these findings.

8
UI - 12082323
AU - Khanna AK; Seth P; Nath G; Dixit VK; Kumar M
TI - Correlation of Helicobacter pylori and gastric carcinoma.
SO - J Postgrad Med 2002 Jan-Mar;48(1):27-8
AD - Department of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221005, India. akk_dr@satyam.net.in
BACKGROUND: Difference of opinion about the prevalence of H. pylori association with gastric cancer exists in the literature. AIMS: To study the correlation of Helicobacter pylori (H. pylori) to gastric carcinoma. METHODS: 50 proved cases of gastric cancer were studied by rapid urease test, culture, histopathology and ELISA test for H. pylori IgG. RESULTS: 68% of cases of gastric cancer were found to be positive for H. pylori infection as compared to 74% of healthy controls. CONCLUSIONS: The prevalence rate of H. pylori infection in our patients of gastric cancer was lower than in the control population though statistically not significant, suggesting that H. pylori may not be responsible for gastric carcinogenesis in this population.

9
UI - 12132870
AU - Kim JC; Kim HC; Roh SA; Koo KH; Lee DH; Yu CS; Lee JH; Kim TW; Lee HL;
TI - Beck NE; Bodmer WF hMLH1 and hMSH2 mutations in families with familial clustering of gastric cancer and hereditary non-polyposis colorectal cancer.
SO - Cancer Detect Prev 2001;25(6):503-10
AD - Department of Surgery, University of Ulsan College of Medicine and Asan Institute for Life Sciences, Seoul, Korea.
The pattern of hMLHI and hMSH2 mutations was assessed to identify the genetic correlation between hereditary gastric and colorectal cancers. Four disease groups and their healthy family members were assembled according to the presentation of gastric cancer: FG, familial clustering of gastric cancer (n = 32); CG, family with one or more colorectal and gastric cancers in first-degree relatives (n = 22); HS, seven HNPCC families corresponding to the Amsterdam criteria (AMS+) and 12 suspected HNPCC families which did not satisfy one of the criteria (AMS-), but no gastric cancer among first- and second-degree relatives (n = 19); and SG, sporadic gastric cancer (n = 33). In the CG group, three were included in AMS + and six in AMS- criteria. Peripheral blood was obtained from them to detect hMLHI and hMLH2 mutations using PCR-SSCP analysis and direct sequencing. The incidence of mutations was 9.4% in the FG group, 54.5% in the CG group, 31.6% in the HS group, and none in the SG group. The incidence, type, and number of the mutation were not different between the CG and HS groups. Thirty-four different mutations included 19 in hMLH1 and 15 in hMSH2. Gastric cancer was the most common extracolonic malignancy in HNPCC and suspected HNPCC families (9/28, 32.1%). The hMLH1 or hMSH2 mutation occurred in seven of 10 families with AMS+, whereas it occurred in four of 18 with AMS- (70% vs. 22.2%, P = .013). Five mutations in the hMLH1 and six mutations in the hMSH2 were exclusively found in families with gastric cancer. All three mutations in the FG group were in hMLHI and there was no mutation in their healthy family members. This study demonstrates that some familial clustering type of gastric cancer appears to be associated with hMLHI mutations thereby indicating a difference from the hereditary gastric cancer studies previously reported. In addition, hMLHI and hMSH2 mutations may impact the gastric cancer carcinogenesis in HNPCC or suspected HNPCC.

10
UI - 12130478
AU - Barth TF; Bentz M; Leithauser F; Stilgenbauer S; Siebert R; Schlotter M;
TI - Schlenk RF; Dohner H; Moller P Pathogenic complexity of gastric B-cell lymphoma.
SO - Blood 2002 Aug 1;100(3):1095-6; discussion 1096-7

11
UI - 11257625
AU - Abraham SC; Singh VK; Yardley JH; Wu TT
TI - Hyperplastic polyps of the stomach: associations with histologic patterns of gastritis and gastric atrophy.
SO - Am J Surg Pathol 2001 Apr;25(4):500-7
AD - Division of Gastrointestinal/Liver Pathology, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205-2196, USA. sabraham@jhmi.edu
Hyperplastic polyps are common gastric lesions characterized by hyperplastic foveolae with variable amounts of inflamed stroma. Their pathogenesis is unknown, but they have been reported to occur in association with various forms of chronic gastritis, particularly autoimmune gastritis and Helicobacter pylori gastritis. Comprehensive histologic evaluation of the background mucosal pathology in patients with hyperplastic polyps has not been previously performed. We studied 160 patients with gastric hyperplastic polyps and characterized endoscopic and histologic features of the polyps (i.e., location, multiplicity, and presence of dysplasia and adenocarcinoma) and the background gastric mucosa (i.e., intestinal metaplasia, dysplasia, carcinoma, and presence and classification of gastritis). Hyperplastic polyps were most common in the antrum (60%) and were multiple in 20% of patients. Focal intestinal metaplasia of the polyp was present in 16% and dysplasia in 4% of patients. Only one patient (0.6%) had adenocarcinoma within the polyp. Evaluation of the surrounding gastric mucosa showed at least focal intestinal metaplasia in 37% of patients, adenoma or low-grade flat epithelial dysplasia in 2%, and synchronous or metachronous adenocarcinoma in 6%. Eighty-five percent of patients had inflammatory mucosal pathology, most commonly active chronic H. pylori gastritis (25%), reactive or chemical gastropathy (21%), and metaplastic atrophic gastritis of the autoimmune (12%) or environmental (8%) type. These results indicate a strong association between various forms of gastritis and the development of hyperplastic polyps and further emphasize the importance of biopsy of the nonpolypoid gastric mucosa during endoscopic examination.

12
UI - 11446880
AU - Hiyama T; Haruma K; Kitadai Y; Masuda H; Miyamoto M; Ito M; Kamada T;
TI - Tanaka S; Uemura N; Yoshihara M; Sumii K; Shimamoto F; Chayama K Clinicopathological features of gastric mucosa-associated lymphoid tissue lymphoma: a comparison with diffuse large B-cell lymphoma without a mucosa-associated lymphoid tissue lymphoma component.
SO - J Gastroenterol Hepatol 2001 Jul;16(7):734-9
AD - First Department of Internal Medicine, Hiroshima University School of Medicine, Hiroshima, Japan.
BACKGROUND AND AIMS: The aim of this study was to clinicopathologically distinguish the pathogenesis of gastric mucosa-associated lymphoid tissue (MALT) lymphoma and diffuse large B-cell lymphoma without a MALT lymphoma component (DLL). METHODS: We investigated clinicopathological features of these gastric lymphomas including age, sex ratio, tumor location and depth, macroscopic appearance, and infection with Helicobacter pylori of these gastric lymphomas and hepatitis viruses in 24 patients with gastric low-grade MALT lymphoma, 10 patients with high-grade MALT lymphoma, and 19 patients with DLL. The frequency of H. pylori infection in lymphoma patients was compared with that in age- and sex-matched control subjects. RESULTS: There was a predominance of females with MALT lymphoma (male to female ratio, 8/16 for low-grade MALT lymphomas and 1/9 for high-grade MALT lymphomas), and there was a predominance of males with DLL (male to female ratio, 13/6); the ratios differed significantly (P < 0.05). Ninety-two percent of low-grade MALT lymphomas and 80% of high-grade MALT lymphomas were confined to the mucosal and submucosal layers, but lymphoma cells invaded the muscular layer or more deeply in 74% of DLL. Helicobacter pylori infection occurred significantly more often in patients with low-grade MALT lymphoma than in age- and sex-matched controls (96 vs 67%, P < 0.01). Conversely, the frequency of H. pylori infection in DLL patients did not differ from that in controls. CONCLUSIONS: These data suggest that H. pylori infection may be associated with the development of gastric MALT lymphoma, but not DLL, and that MALT lymphoma and DLL may have a different pathogenesis.

13
UI - 11552443
AU - Calvo Belmar A; Pruyas M; Nilsen E; Verdugo P
TI - [Populational research of gastric cancer in digestive symptomatic patients, from 1996 to 2000]
SO - Rev Med Chil 2001 Jul;129(7):749-55
AD - Unidad de Endoscopia, Centro de Referencia de Salud San Rafael, La Florida, Santiago, Chile. acalvob@entelchile.net
BACKGROUND: Gastric cancer is the first cause of death due to malignant tumors in Chile. Its mortality rates have stabilized in the last two decades and its prognosis is closely associated to the degree of tumor invasion at the moment of surgery. AIM: To study the frequency of gastric cancer among symptomatic patients subjected to an upper gastrointestinal endoscopy at a secondary care health center. PATIENTS AND METHODS: All upper gastrointestinal endoscopies performed to patients derived from public primary care clinics were recorded. RESULTS: In the study period, 4,145 endoscopies were done to 818 men and 2,128 women. Seventy one percent of patients were aged over 40 years of age. Fifty one carcinomas and one lymphoma were detected. Of these, 10 tumors were incipient. Thirty one patients were operated on and in 22 a total gastrectomy was performed. One patient, that required an esophageal resection, died. CONCLUSIONS: Gastric cancer was detected in 1.2% of symptomatic adult patients subjected to an upper gastrointestinal endoscopy.

14
UI - 11917206
AU - Mao Y; Hu J; Semenciw R; White K; Canadian Cancer Registries
TI - Epidemiology Research Group Active and passive smoking and the risk of stomach cancer, by subsite, in Canada.
SO - Eur J Cancer Prev 2002 Feb;11(1):27-38
AD - Surveillance & Risk Assessment, Centre for Chronic Disease Prevention and Control, Population and Public Health Branch, Health Canada, Tunney's Pasture AL0601C1, Ottawa, Ontario K1A 0L2, Canada. Yang_Mao@hc-sc.gc.ca
This study assessed the influence of active and passive smoking on the risk of stomach cancer by subsite. Mailed questionnaires were used to obtain information on 1171 newly diagnosed histologically confirmed stomach cancer cases and 2207 population controls between 1994 and 1997 in eight Canadian provinces. Data were collected on socio-economic status, lifestyle and passive smoking status. Odds ratios (OR) and 95% confidence intervals (95% CI) were derived by logistic regression. Compared with those who had never smoked, there was strongly increased risk for ex- and current smokers among subjects with cardial stomach cancer. For men with cardial cancer, the adjusted ORs were 1.9 (95% CI 1.2-3.0) and 2.6 (95% CI 1.6-4.3) for ex-smokers and current smokers, respectively, with a similar pattern among women. Among men, the adjusted ORs were lower for subsites of stomach cancer other than cardia. These findings suggest that active and passive smoking may play an important role in the development of cardial stomach cancer.

15
UI - 12091074
AU - Amioka T; Kitadai Y; Tanaka S; Haruma K; Yoshihara M; Yasui W; Chayama K
TI - Vascular endothelial growth factor-C expression predicts lymph node metastasis of human gastric carcinomas invading the submucosa.
SO - Eur J Cancer 2002 Jul;38(10):1413-9
AD - First Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Japan.
We examined the relationship between vascular endothelial growth factor (VEGF)-C expression and lymph node metastases in gastric carcinomas invading the submucosa. Of the six human gastric carcinoma cell lines, two constitutively expressed VEGF-C mRNA. In three of 12 gastric biopsy specimens (25%), VEGF-C mRNA was detected in tumour tissues, but not in corresponding normal mucosa by reverse transcriptase-polymerase chain reaction (RT-PCR). Of the 139 resected gastric carcinomas, 44 (32%) showed intense cytoplasmic VEGF-C immunoreactivity in many cancer cells at the invading edge. VEGF-C immunoreactivity was associated with greater depth of tumour invasion, lymphatic invasion and lymph node metastases. In addition, vessel count was also significantly higher in the VEGF-C immunoreactive tumours than in other tumours. These results suggest that VEGF-C may be involved in the progression of human gastric carcinoma, particularly via lymphangiogenesis. VEGF-C expression at the invading edge of a gastric carcinoma may be a sensitive marker for metastasis to the lymph nodes.

16
UI - 12163327
AU - Park J; Schulz S; Haaf J; Kairys JC; Waldman SA
TI - Ectopic expression of guanylyl cyclase C in adenocarcinomas of the esophagus and stomach.
SO - Cancer Epidemiol Biomarkers Prev 2002 Aug;11(8):739-44
AD - Division of Clinical Pharmacology, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Guanylyl cyclase C (GC-C), a receptor specifically expressed in cells originating from differentiated intestinal epithelium, is a marker and therapeutic target for colorectal cancer metastases. Intestinal metaplasia, in which epithelial cells assume histological and molecular characteristics of differentiated intestinal enterocytes, is a common precursor to adenocarcinomas of the esophagus and stomach. Thus, those tumors, tissues adjacent to them, and their associated regional lymph nodes were assessed for GC-C expression by reverse transcription coupled with the PCR. GC-C mRNA was detected in five of five and eight of nine esophageal and gastric adenocarcinomas, respectively. Also, GC-C mRNA was detected in three of five and six of seven tissues adjacent to, but not histologically involved in, esophageal and gastric adenocarcinomas, respectively, reflecting molecular changes associated with neoplastic transformation preceding histopathological changes. In contrast, three normal gastric specimens did not express GC-C. Furthermore, GC-C mRNA was detected in 1 of 1 lymph node containing tumor cells by histopathology from a patient with gastric adenocarcinoma and in 3 of 11 lymph nodes, all of which were free of tumor cells by histopathology, from a patient with a gastroesophageal junction tumor. This is the first demonstration that GC-C is ectopically expressed by primary and metastatic adenocarcinomas of the esophagus and stomach and suggests that GC-C may be a sensitive and specific clinical marker and target for adenocarcinomas of the upper gastrointestinal tract.

17
UI - 12177800
AU - Hoshiyama Y; Kawaguchi T; Miura Y; Mizoue T; Tokui N; Yatsuya H; Sakata
TI - K; Kondo T; Kikuchi S; Toyoshima H; Hayakawa N; Tamakoshi A; Ohno Y; Yoshimura T; Japan Collaborative Cohort Study Group A prospective study of stomach cancer death in relation to green tea consumption in Japan.
SO - Br J Cancer 2002 Jul 29;87(3):309-13
AD - Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo 142-8555, Japan. yhkiss@med.showa-u.ac.jp
To evaluate whether green tea consumption provides protection against stomach cancer death, relative risks were calculated using Cox proportional hazards regression analysis in the Japan Collaborative Study for Evaluation of Cancer Risk, sponsored by the Ministry of Health and Welfare (JACC Study). The study was based on 30 370 men and 42 481 women aged 40-79. After adjustment for age, smoking status, history of peptic ulcer, family history of stomach cancer along with certain dietary items, the risks associated with drinking one or two, three or four, five to nine, and 10 or more cups of green tea per day, relative to those of drinking less than one cup per day, were 1.6 (95% CI: 0.9-2.9), 1.1 (95% CI: 0.6-1.9), 1.0 (95% CI: 0.5-2.0), and 1.0 (95% CI: 0.5-2.0), respectively, in men (P for trend=0.669), and 1.1 (95% CI: 0.5-2.5), 1.0 (95% CI: 0.5-2.5), 0.8 (95% CI: 0.4-1.6), and 0.8 (95% CI: 0.3-2.1), respectively, in women (P for trend=0.488). We found no inverse association between green tea consumption and the risk of stomach cancer death. Copyright 2002 Cancer Research UK

18
UI - 8239771
AU - Longmire WP Jr
TI - A current view of gastric cancer in the US.
SO - Ann Surg 1993 Nov;218(5):579-82
In the US, the remarkable decline in the incidence of gastric cancer during the mid-portion of this century has leveled off during the last two decades as an equally remarkable and poorly understood increase in the percentage of the generally more unfavorable cardia cancers has become apparent. The importance of H. pylori infection is being actively investigated and treatment to reduce the infection may offer a means of decreasing the disease, particularly in areas of high incidence. The potential danger of inciting gastric cancer by the prolonged use of drugs that severely reduce or eliminate gastric acid has been mentioned, but the degree of risk must await the passage of years before it can be properly evaluated. "Early gastric cancer" or, probably more appropriately, "superficial gastric adenocarcinoma" continues to comprise a relatively small segment of gastric cancers in the US and most Western countries. Seventeen per cent of cases in the ACS series were classified as stage I, a much higher incidence than reported for early gastric cancer in most individual North American series. The ACS report suggests "special education of the surgeon in the requisites for adequate gastrectomy with node dissection, coupled with effective adjuvant therapy" as a means of improving results in the US. This is a significant consideration because, unfortunately, gastric surgery for ulcer or cancer no longer plays the important role it did in past decades in many US surgical training programs. As has been demonstrated in Japan and in certain larger US series, excellent surgical technique, particularly for cardia tumors, plays an important role in obtaining improved results. The value of radical lymph node dissection continues to be controversial in US cases, and a successful chemotherapeutic regimen has yet to be found. Subtotal gastric resection, as noted in the ACS report, continues to be the procedure of choice in the US for most gastric cancers, even for cardia cancers. Although there is no improvement in survival, quality of life is thought by some to be better after total gastrectomy for cardia cancers rather than proximal subtotal esophagogastrectomy. However, equally important for improved survival is the ACS recommendation of earlier referral for gastric surgery patients with precursor lesions, but the lack of improvement in the pathological stage of disease in the two ACS time periods suggests that little progress is being made in this country in this regard.

19
UI - 8239772
AU - Wanebo HJ; Kennedy BJ; Chmiel J; Steele G Jr; Winchester D; Osteen R
TI - Cancer of the stomach. A patient care study by the American College of Surgeons.
SO - Ann Surg 1993 Nov;218(5):583-92
AD - Department of Surgery, Roger Williams Hospital, Brown University, Providence, Rhode Island.
OBJECTIVE. The major purpose of this study was to document the modes of presentation, diagnostic methods, clinical management, and outcome of gastric cancer as reported by tumor registries of US hospitals and cancer programs approved by the American College of Surgeons. SUMMARY BACKGROUND DATA. Gastric cancer continues to diminish in the US, but the stage of disease and survival outcome after surgical resection is unchanged despite increased availability and sophistication of diagnostic techniques. This is in contrast to the marked improvement in survival outcome in Japanese and other Eastern series over the last decades. Possible reasons for the improved Japanese results have been earlier detection secondary to active diagnostic surveillance of the population and widespread adoption of aggressive surgical resection emphasizing wide-field node (R2) dissection. Although selected US centers using the Japanese approach report better survival data, the approach has not been widely adapted by US treatment centers. METHODS. Tumor registries at American College of Surgeons (ACS) approved hospitals were mailed a study protocol in 1987. They were instructed to review 25 consecutive patients with gastric cancer treated in 1982 (long-term study) and 25 patients treated in 1987 (short-term study). A detailed protocol included significant history, diagnostic results, staging, pathology findings, and treatment results. The data forms on 18,365 patients were returned and analyzed (11,264 patients in the long-term study and 7101 patients in the short-term study). RESULTS. Of 18,365 patients, 63% were males. The median ages were 68.4 years in males and 71.9 years in females. There was a history of gastric ulcer in 25.5% of the patients. Lesion location was upper third in 31%, middle third in 14%, distal third in 26%, and entire stomach in 10% of patients (and the site was unknown in 19%). Gastric resection was performed for 80% of upper third cancers and 85% of distal third cancers; 50% of patients with total gastric involvement had gastric resection. The extent of gastric resection varied according to location. For lower third lesions, subtotal gastrectomy was done in 55% of the cases, extended resection in 21%, and total gastrectomy in 6%. For proximal lesions, 29% had subtotal, 4.6% had total, and 41% had extended gastrectomies (including esophagus), and 13.6% had dissection of celiac nodes. The operative mortality rate was 7.2%. Staging (American Joint Committee on Cancer [AJCC]) was as follows: I, 17%; II, 17%; III, 36%; and IV, 31%. The overall survival rate reflecting deaths from all causes was 14% among 10,891 patients diagnosed in 1982, and it was 19% in patients having resection. The disease specific survival rate was 26%. The survival rate after resection was 19% and 21% for lower and mid third cancers, 10% for upper third cancers, and 4% if the entire stomach was involved. The stage-related survival rates were 50% (stage I), 29% (stage II), 13% (stage III), and 3% (stage IV). Among patients with pathologically clear margins, the survival rate was 35% versus 13% in those with microscopically involved margins, and it was 3% in those with grossly involved margins. CONCLUSION. This report of gastric cancer treatment by American College of Surgeons approved institutions in the US provides an overview of the disease as commonly treated throughout the US. Although the results are less favorable than those reported by centers with large institutional experiences with this disease and are inferior to those of the Japanese and other Eastern centers, they suggest potential for increasing survival by upstaging through earlier diagnosis and using resectional techniques demonstrated to more adequately control local regional disease.

20
UI - 11594522
AU - Hashimoto T; Takishita M; Kosaka M; Sano T; Matsumoto T
TI - Superantigens and autoantigens may be involved in the pathogenesis of gastric mucosa-associated lymphoid tissue lymphoma.
SO - Int J Hematol 2001 Aug;74(2):197-204
AD - First Department of Internal Medicine, School of Medicine, University of Tokushima, Japan. toshiha@clin.med.tokushima-u.ac.jp
To clarify the origin of tumor cells and the possible role of antigens in the pathogenesis of mucosa-associated lymphoid tissue lymphoma (MALTL) of the stomach, we analyzed the DNA sequences of the immunoglobulin (Ig) variable region gene from tumor cells of 4 patients with low-grade and 2 patients with high-grade MALTL associated with Helicobacter pylori infection. There were few somatic mutations in the Ig variable region gene, but intraclonal variations were observed in 2 of the 4 low-grade MALTL cases. In the remaining 2 low-grade MALTL and 1 of the 2 high-grade MALTL cases, somatic mutations and intraclonal variations were evident. In contrast, somatic mutations in the Ig variable region gene were prominent, but intraclonal variation was absent in the other high-grade MALTL cases. The deduced amino acid sequences of the antigen-binding fragments (Fab) from 2 MALTL cases revealed homology with anti-thyroglobulin antibodies, 3 MALTL cases with lupus anti-DNA antibodies, and 1 MALTL case with a rheumatoid factor. Furthermore, the heavy-chain variable region 3 (V(H)3) family genes were used in 5 of the 6 MALTL cases and had conserved amino acid residues for binding to staphylococcal protein A (SpA), a superantigen of B cells. Considering that another superantigen, protein Fv, competes for binding to Fab with SpA and has been shown to play a major role in immune defenses against gut pathogens, SpA and possibly protein Fv may contribute to the development of MALTL. Thus, these observations suggest that most gastric MALTLs arise from memory B cells that are preliminarily activated by superantigens and autoantigens.

21
UI - 12111686
AU - Engel LS; Vaughan TL; Gammon MD; Chow WH; Risch HA; Dubrow R; Mayne ST;
TI - Rotterdam H; Schoenberg JB; Stanford JL; West AB; Blot WJ; Fraumeni JF Jr Occupation and risk of esophageal and gastric cardia adenocarcinoma.
SO - Am J Ind Med 2002 Jul;42(1):11-22
AD - Occupational Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA. engell@mail.nih.gov
BACKGROUND: Adenocarcinomas of the esophagus and gastric cardia have risen dramatically in incidence over the past few decades, however, little research has been conducted on the occupational risk factors for these cancers. METHODS: In this population-based case-control study, lifetime job histories were compared between cases of esophageal adenocarcinoma (n = 283), gastric cardia adenocarcinoma (n = 259), and population controls (n = 689). Odds ratios (OR) and 95% confidence intervals (CI) for ever employment and by duration in various occupational and industrial categories were calculated using unconditional logistic regression. RESULTS: The risk of esophageal adenocarcinoma was elevated for persons ever employed in administrative support (OR = 1.5; 95%CI = 1.0-2.1); financial, insurance, and real estate (OR = 1.6; 95%CI = 1.0-2.4); and health services (OR = 2.2; 95%CI = 1.2-3.9). The risk of gastric cardia adenocarcinoma was increased among transportation workers (OR = 1.7; 95%CI = 1.1-2.6), as well as among carpenters (OR = 1.8; 95%CI = 0.9-3.9) and workers in the furniture manufacturing industry (OR = 2.4; 95%CI = 0.9-6.3). However, we observed few duration-response relations between length of employment in any category and cancer risk. CONCLUSIONS: This study revealed associations of esophageal adenocarcinoma with employment in administrative support, health services, and a category of financial, insurance, and real estate industries, and of gastric cardia adenocarcinoma with transportation and certain woodworking occupations. Some of these findings may be due to the play of chance associated with the multiple comparisons made in this study. Our results suggest that, overall, workplace exposures play a minor role in the etiology and upward trend of esophageal and gastric cardia adenocarcinomas.

22
UI - 12136244
AU - Friedl W; Uhlhaas S; Schulmann K; Stolte M; Loff S; Back W; Mangold E;
TI - Stern M; Knaebel HP; Sutter C; Weber RG; Pistorius S; Burger B; Propping P Juvenile polyposis: massive gastric polyposis is more common in MADH4 mutation carriers than in BMPR1A mutation carriers.
SO - Hum Genet 2002 Jul;111(1):108-11
AD - Institute of Human Genetics, University of Bonn, Wilhelmstrasse 31, Germany. waltraut.friedl@ukb.uni-bonn.de
Juvenile polyposis syndrome (JPS) is an autosomal dominant predisposition to multiple juvenile polyps in the gastrointestinal tract. Germline mutations in the MADH4 or BMPR1A genes have been found to be causative of the disease in a subset of JPS patients. So far, no genotype-phenotype correlation has been reported. We examined 29 patients with the clinical diagnosis of JPS for germline mutations in the MADH4 or BMPR1A genes and identified MADH4 mutations in seven (24%) and BMPR1A mutations in five patients (17%). A remarkable prevalence of massive gastric polyposis was observed in patients with MADH4 mutations when compared with patients with BMPR1A mutations or without identified mutations. This is the first genotype-phenotype correlation observed in JPS.

23
UI - 12095972
AU - Hyung WJ; Lee JH; Choi SH; Min JS; Noh SH
TI - Prognostic impact of lymphatic and/or blood vessel invasion in patients with node-negative advanced gastric cancer.
SO - Ann Surg Oncol 2002 Jul;9(6):562-7
AD - Department of Surgery, the Cancer Metastasis Research Center, Yonsei University College of Medicine, Seoul, Korea.
BACKGROUND: Heterogeneous survival rates in patients with similar clinicopathologic characteristics or molecular prognostic markers have been noted. This study was conducted to evaluate the prognostic effect of lymphatic and/or blood vessel invasion (LBVI), identified by routine hematoxylin and eosin staining, on the outcome of patients with node-negative advanced gastric cancer. METHODS: A total of 280 patients who underwent curative gastrectomy for advanced gastric cancer without lymph node metastasis were retrospectively reviewed. Univariate and multivariate analyses of the clinicopathological features, recurrences, and prognoses of patients with and without LBVI were performed. RESULTS: Lymphatic vessel invasion (LVI) was noted in 20.0%, blood vessel invasion (BVI) in 5.4%, and either LVI or BVI in 22.5%. None of the clinicopathologic features was related to LBVI. Patients with LBVI had a recurrence rate of 26.8%, whereas patients without LBVI had a recurrence rate of 13.5% (P =.018). The 5-year survival rates were 82.4% for patients without LBVI and 67.1% for patients with LBVI (P =.0222). LBVI was shown to be an independent risk factor for recurrence (relative risk, 2.30; 95% confidence interval, 1.06-4.99) and poor prognosis (relative risk, 1.88; 95% confidence interval, 1.07-3.29). CONCLUSIONS: LBVI is an adverse prognostic indicator and the presence of LBVI seems to provide useful information for the prognosis and clinical management of patients with node-negative advanced gastric carcinoma.

24
UI - 12135039
AU - Tursi A; Brandimante G; Chiarelli F; Spagnoli A; Torello M
TI - Detection of HCV RNA in gastric mucosa-associated lymphoid tissue by in situ hybridization: evidence of a new extrahepatic localization of HCV with increased risk of gastric malt lymphoma.
SO - Am J Gastroenterol 2002 Jul;97(7):1802-6
AD - Department of Emergency Medicine, L Bonomo Hospital, Andria, Italy.
OBJECTIVES: Mucosa-associated lymphoid tissue (MALT) is absent in the normal gastric mucosa but it can develop in several conditions, such as Helicobacter pylori infection. A certain correlation between hepatitis C virus (HCV) infection and low grade MALT lymphomas has recently been reported. The aim of this study was to investigate the presence of HCV RNA in acquired gastric MALT of HCV-infected patients using the in situ hybridization technique. METHODS: Twenty-five patients (16 male and nine female, average age = 56.6 yr [range = 33-75]) affected by chronic HCV hepatitis and with gastric MALT were studied. Giemsa stain and the rapid urease test were also used to evaluate the presence of H. pylori. A polymerase chain reaction product corresponding to the complete 5' noncoding region of the HCV genome was cloned directly in the pCR 1000 vector on gastric biopsies with acquired MALT. RESULTS: Twenty patients showed grade 2 gastric MALT and five showed grade 3, and H. pylori's presence was detected in 18 of 25 patients (72%). Using in situ hybridization, we detected HCV RNA in gastric acquired MALT of seven of 25 patients (28%): five showed grade 2 gastric MALT (two of these were H. pylori negative and the other three were positive), whereas two patients showed grade 3 gastric MALT (without H. pylori infection). CONCLUSIONS: This study shows that HCV not only may colonize gastric MALT but also may permit the development of a grade of acquired MALT, which may represent the first step toward a MALT lymphoma. However, further studies are needed to demonstrate the antigenic role of HCV in the progression of acquired MALT into MALT lymphoma.

25
UI - 11697492
AU - Kanda M; Suzumiya J; Ohshima K; Okada M; Tamura K; Kikuchi M
TI - Changes in pattern of immunoglobulin heavy chain gene rearrangement and MIB-1 staining before and after eradication of Helicobacter pylori in gastric mucosa-associated lymphoid tissue (MALT) lymphoma.
SO - Leuk Lymphoma 2001 Aug;42(4):639-47
AD - First Department of Pathology, School of Medicine, Fukuoka University, School of Medicine, Japan.
Gastric low-grade mucosa-associated lymphoid tissue (MALT) lymphomas are strongly associated with infection by Helicobacter pylori (H. pylori). Antibiotic treatment for H. pylori induces a sustained remission in a significant number of patients. We report here the outcome in 13 patients with gastric low-grade MALT lymphomas or suspected gastric lesions, treated for eradication of H. pylori. Patients were followed closely with sequential histological studies, polymerase chain reaction (PCR) amplification of the immunoglobulin heavy chain (IgH) gene and immunohistochemistry for MIB-1. Antibiotic therapy resulted in eradication of H. pylori in all but one case, as assessed histologically. In 12 cases with successful eradication, complete regression was observed histologically in 9 cases (75%) and no regression in 3 (25%). In 7 of 9 (78%) patients who had a complete remission, clonal bands of IgH gene detected on PCR before therapy disappeared after therapy. All 9 patients with complete regression showed a reduced number of MIB-1 positive cells, while 4 cases with no change or disease progression showed no change or increased number of MIB-1 positive cells. There was a strong relationship between density of MIB-1-positive cells and histological score. These results indicate that combination analysis of PCR of IgH and MIB-1 seems to represent a very good current approach for the diagnosis of gastric low-grade MALT lymphoma and to assess the effects of chemotherapy, especially in problematic cases.

26
UI - 12149167
AU - Chiba T
TI - Factors contributing to the development of gastric cancer due to Helicobacter pylori infection.
SO - Curr Gastroenterol Rep 2002 Aug;4(4):267-8
AD - Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kawahara-cho 54, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. cteya@kuhp.kyoto-u.ac.jp

27
UI - 12151659
AU - Thompson AG
TI - Regional differences in incidence of gastric and colonic cancer in the Maori of New Zealand.
SO - Postgrad Med J 2002 Jul;78(921):419-21
AD - Queen Elizabeth Hospital, Birmingham B15 2TH. ag_thompson@yahoo.com
BACKGROUND: It is known that there are ethnic differences in cancer in New Zealand between Maori (the indigenous people) and non-Maori, however, until now no regional comparisons have been made. STUDY DESIGN: A retrospective study of patients diagnosed at Whangarei Hospital, New Zealand between 1995 and 1997 with gastric or colonic cancer was combined with population data from the 1996 census for Whangarei District to calculate incidence figures. The incidence of cancer was compared to national rates. RESULTS: Between 1995 and 1997, 19 Maori and 24 non-Maori were diagnosed with gastric cancer, and 10 Maori and 125 non-Maori with colonic cancer. The age standardised rates (per 100,000) for Maori and non-Maori with gastric caner were 68.3 and 7.9 respectively. Gastric cancer is known to be increased in the Maori, but in Whangarei was significantly higher than the national Maori rates (20.5). There was no difference in the rate of colonic cancer in the Maori and non-Maori in Whangarei, again this differs from the national trends, in which the Maori are protected against cancer. CONCLUSION: This study highlights that there is still much more to be learnt in understanding the aetiology of gastrointestinal cancers, to explain such strong regional differ

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NCI CANCERLIT^® Search: Diagnosis-Histopathology-Pathogenesis of Gastric Cancer - September 2002