| Theme |
Diagnosis and Treatment of Scirrhous Gastric Cancer -- Current Status and Future Prospects |
| Title |
Early Detection of Gastric Cancer Showing Highly Malignant Potential: for the Identification of High-risk Subjects of Scirrhous Gastric Cancer by the Combination of Serological Tests and Endoscopic Findings |
| Author |
Mika Watanabe |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Shotaro Enomoto |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Takeichi Yoshida |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Masao Ichinose |
Second Department of Internal Medicine, Wakayama Medical University |
| [ Summary ] |
Scirrhous gastric cancer is a rare subtype of gastric cancer exhibiting higher malignant potential. It is composed of a poorly differentiated mixture of mucin-producing carcinoma cells which infiltrate the muscle wall and turn the stomach tissue rigid and leathery. Although marked advances have been made in the diagnosis and treatment of gastric cancer, and clear improvements in prognosis have been attained, the 5-year survival rate for this subtype of gastric cancer remains within the 0-16.2 % range. The molecular mechanisms involved in the proliferation, migration and metastasis of scirrhous gastric cancer, which confer high malignant potentials, are still unclear. Furthermore, precancerous or high-risk lesions for histologically poorly differentiated cancer, including scirrhous gastric cancer, are not fully known. Our recent long-term follow-up study of 496 asymptomatic, middle-aged, H. pylori-infected subjects without extensive chronic atrophic gastritis revealed that subjects with highly active gastritis as identified by two serological tests (the pepsinogen test and H. pylori antibody titer) and endoscopic rugal hyperplastic gastritis constitute a group at high risk of developing cancer with a H. pylori-infected non-atrophic stomach. These results suggest new avenues for identifying a previously undescribed group at high risk of developing poorly differentiated cancer directly from the non-atrophic stomach. |