Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Intracellular gold nanoparticles enhance non-invasive radiofrequency thermal destruction of human gastrointestinal cancer cells
Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Taurolidine reduces the tumor stimulating cytokine interleukin-1beta in patients with resectable gastrointestinal cancer: a multicentre prospective randomized trial
Tumors of the Stomach
Incidence and Epidemiology
For unclear reasons, the incidence and mortality rates for gastric cancer have decreased markedly during the past 75 years. The mortality rate from gastric cancer in the United States has dropped in men from 28 to 5.8 per 100,000 persons, while in women the rate has decreased from 27 to 2.8 per 100,000. Nonetheless, 21,260 new cases of stomach cancer were diagnosed in the United
States, and 11,210 Americans died of the disease in 2007.
Imatinib has also demonstrated targeted activity in other diseases, including gastrointestinal stromal tumors (GIST), rare mesenchymal tumors of the GI tract (stomach and small intestine). The pathogenic molecular event for most patients with this disease is mutation of the proto-oncogene c-Kit, leading to the constitutive activation of this receptor tyrosine kinase without the binding of its physiologic ligand, stem cell factor. About 10% of GISTs encode activating mutations of the PDGFRα instead of c-Kit.
Etiology and Risk Factors Risk factors for the development of colorectal cancer are listed in Table 874.
Table 87-4 Risk Factors for the Development of Colorectal Cancer
Diet: Animal fat
Hereditary syndromes (autosomal dominant inheritance)
Nonpolyposis syndrome (Lynch syndrome)
Inflammatory bowel disease
Streptococcus bovis bacteremia
? Tobacco use
The etiology for most cases of large-bowel cancer appears to be related to environmental factors. The disease occurs more often in upper socioeconomic populations who live in urban areas.
Table 87-5 Hereditable (Autosomal Dominant) Gastrointestinal Polyposis Syndromes
tion of Polyps gic Type
Familial adenomatous polyposis
Large intestine a
fibromas, lipomas, epidermoid cysts, ampullary cancers, congenital hypertrophy retinal of
Large intestine a
Endometri and ovarian
posis syndrome int...
Palliation Surgery is employed in a number of ways for supportive care: insertion of central venous catheters, control of pleural and pericardial effusions and ascites, caval interruption for recurrent pulmonary emboli, stabilization of cancerweakened weight-bearing bones, and control of hemorrhage, among others. Surgical bypass of gastrointestinal, urinary tract, or biliary tree obstruction can alleviate symptoms and prolong survival. Surgical procedures may provide relief of otherwise intractable pain or reverse neurologic dysfunction (cord decompression).
Mucositis Irritation and inflammation of the mucous membranes particularly afflicting the oral and anal mucosa, but potentially involving the gastrointestinal tract, may accompany cytotoxic chemotherapy. Mucositis is due to damage to the proliferating cells at the base of the mucosal squamous epithelia or in the intestinal crypts. Topical therapies, including anesthetics and barrier-creating preparations, may provide symptomatic relief in mild cases.
Harrison's Internal Medicine Chapter 87. Gastrointestinal Tract Cancer
Gastrointestinal Tract Cancer: Introduction
The gastrointestinal tract is the second most common noncutaneous site for cancer and the second major cause of cancer-related mortality in the United States.
Incidence and Etiology Cancer of the esophagus is a relatively uncommon but extremely lethal malignancy. The diagnosis was made in 15,560 Americans in 2007 and led to
13,940 deaths. Worldwide, the incidence of esophageal cancer varies strikingly. ...
Clinical Features About 10% of esophageal cancers occur in the upper third of the esophagus (cervical esophagus), 35% in the middle third, and 55% in the lower third. Squamous cell carcinomas and adenocarcinomas cannot be distinguished radiographically or endoscopically.
Progressive dysphagia and weight loss of short duration are the initial symptoms in the vast majority of patients. Dysphagia initially occurs with solid foods and gradually progresses to include semisolids and liquids.
Hereditary Nonpolyposis Colon Cancer Hereditary nonpolyposis colon cancer (HNPCC), also known as Lynch syndrome, is another autosomal dominant trait. It is characterized by the presence of three or more relatives with histologically documented colorectal cancer, one of whom is a first-degree relative of the other two; one or more cases of colorectal cancer diagnosed before age 50 in the family; and colorectal cancer involving at least two generations. In contrast to polyposis coli, HNPCC is associated with an unusually high frequency of cancer arising in the proximal large bowel.
Screening The rationale for colorectal cancer screening programs is that earlier detection of localized, superficial cancers in asymptomatic individuals will increase the surgical cure rate. Such screening programs are important for individuals having a family history of the disease in first-degree relatives. The relative risk for developing colorectal cancer increases to 1.75 in such individuals and may be even higher if the relative was afflicted before age 60.
Most recurrences after a surgical resection of a large-bowel cancer occur within the first 4 years, making 5-year survival a fairly reliable indicator of cure. The likelihood for 5-year survival in patients with colorectal cancer is stagerelated (Fig. 87-3). That likelihood has improved during the past several decades when similar surgical stages have been compared. The most plausible explanation for this improvement is more thorough intraoperative and pathologic staging.
Radiation therapy to the pelvis is recommended for patients with rectal cancer because it reduces the 20–25% probability of regional recurrences following complete surgical resection of stage II or III tumors, especially if they have penetrated through the serosa.
Cancers of the Anus Cancers of the anus account for 1–2% of the malignant tumors of the large bowel. Most such lesions arise in the anal canal, the anatomic area extending from the anorectal ring to a zone approximately halfway between the pectinate (or dentate) line and the anal verge. Carcinomas arising proximal to the pectinate line (i.e., in the transitional zone between the glandular mucosa of the rectum and the squamous epithelium of the distal anus) are known as basaloid, cuboidal, or cloacogenic tumors; about one-third of anal cancers have this histologic pattern.
We especially paid attention not to
distend the bladder too much to prevent a high irrigation pressure and a resultant TUR
syndrome. Special attention was paid to avoid the injury to Santorini’s plexus and the
rectum. The procedure was started from the 12 o’clock position, dividing the prostate into
6 parts, and resected specimens were collected separately to examine the distribution of
cancer. The seminal vesicle was partially resected at its attached part to the prostate
between the 4 and 8 o’clock positions to determine the invasion of cancer.
In 1991 I was presenter of the BBC’s Watchdog programme, married to my copresenter
John Stapleton with a two-year-old son. Life was good. I had never
heard of bowel cancer, had no idea that it was the second biggest cancer killer
in the UK. So I had no worries that the subtle symptom I had spotted intermittently
– just a bit of rectal bleeding – might be serious.
When my GP reassured me that it was ‘nothing to worry about’ at my age,
‘probably piles’, I believed him. It was a terrible shock to discover nearly a
year later, through my persistence, that I had advanced bowel...
ADH1 and ADH4 are the major alcohol dehydrogenases
(ADH) in ethanol and retinol oxidation. ADH activity and
protein expression were investigated in rat gastrointestinal
tissuehomogenates by enzymatic andWesternblot analyses.
In addition, sections of adult rat gastrointestinal tract were
examined byin situ hybridization and immunohistochem-istry.ADH1andADH4weredetectedalong thewhole tract,
changing their localization and relative content as a function
of the area studied.
Study the clinical characteristics, endoscopy, histopathology, expression of proteins p53, Ki67, Her- 2/neu in colorectal cancer and colorectal polyps greater than or equal to 10 mm; study the relationship between the expression of proteins p53, Ki67 and Her- 2/neu with histopathological characteristics, lymph node metastasis in colorectal cancer and colorectal polyps greater than or equal to 10 mm.
(BQ) Part 1 book "Carly cancer of the gastrointestinal tract endoscopy, pathology, and treatment" presents the following contents: Case presentations - Clinical data, endoscopy, and pathology; vienna consensus criteria for pathological diagnosis; early neoplasia in barrett’s esophagus.