BCM
Gastroenterology Grand Rounds - Take Home Lessons
The main lessons to take home concerning this case
are:
1. Gastric cancer is the second leading cause of cancer
death world-wide.
2. H. pylori is the major cause of both histologic
subtypes (intestinal and diffuse) of gastric cancer.
3. Both histologic subtypes occur in hereditary forms
that do not overlap. Hereditary difuse gastric cancer is associated with
a mutataion in the E-cadherin gene that can be identified in affected families
and may be best treated by prophylactic gastrectomy.
4. EBV is the cause of 10-15% of gastric cancer in Asia.
These tumors with prominent lymphoid infiltration are more proximal and
are not strongly associated with H. pylori infection.
5. Gastric cancer in young people may be due to an inherited
predisposition exascerbated by environmental factors.
