| Theme | Risk Factors for Gastric Carcinogenesis | |
|---|---|---|
| Title | Experimental and Clinicopathological Studies on Carcinogenesis of the Gastric Remnants | |
| Publish Date | 2004/03 | |
| Author | Michio Kaminishi | Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo |
| Author | Nobuyuki Shimizu | Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo |
| Author | Hirokazu Yamaguchi | Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo |
| Author | Sachiyo Nomura | Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo |
| Author | Shouji Shimoyama | Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo |
| Author | Ken-ichi Mafune | Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo |
| [ Summary ] | Clinicopathological analysis of patients with gastric remnant cancer showed differences in the interval between the previous gastrectomy and the diagnosis of remnant cancer, and in the location of remnant cancer from the previous disease which was benign or malignant. Furthermore, the histological type of the developed cancer was closely related to the location of the gastric remnant; diffuse type at the anastomosis and intestinal type at the body of the gastric remnant. These results indicate that three major factors at the time of the previous surgery are relevant to different carcinogenesis of the gastric remnant, these are the degree of atrophic gastritis, the scope of denervation and devascularization accompanied with lymph adenectomy, and the fashion of reconstruction which induces duodenogastric reflux. To clarify the role of these factors in gastric remnant carcinogenesis, we performed an experimental study in which a gastric remnant model, in which truncal vagotomy and administration of a low dose of carcinogenic agent was conducted. The results confirmed the important roles of these factors. Therefore, gastric remnant cancers are likely to be divided into three types, based on the mechanism of carcinogenesis; newly developed, cryptic or recurrent cancer. Earlier diagnosis and treatment of gastric remnant cancer, based on the mechanism of gastric remnant carcinogenesis, is highly recommended. | |