Epidemiological and Anatomo Path Ological Aspects of Stomach Cancers at the Koutiala District Hospital

Aim: This paper aims to evaluate the epidemiological and pathological aspects of stomach cancer at Koutiala District Hospital. Methods: This was a retrospective study carried out in the General Surgery Department of the Koutiala District Hospital Health Centre. The records of patients admitted for stomach cancer in the period from August 1, 2017 to December 31, 2022 were collected. Patients who underwent surgery for stomach cancer were included in the study. Patients who had not undergone surgery were excluded. Results: We collected records from 40 patients operated on for stomach cancer. The median age was 58.4 years ± 5.7. Men were in the majority with 72.5% The sex ratio was 2.6. The incidence rate of stomach cancer in the general population in the circle was 4.9 cases per 100,000 population. Patients had a history of gastric ulcer in 90%, Helicobacter pylori infection in 47.5% and a notion of excessive salt consumption in 47.5%. The median duration of disease progression was 5 years ± 2.3. The seat was antro-pyloric in 77.5%. The cancer was ulcerative budding in 23 patients. Adenocarcinoma was the histological type in all patients. The cancer was classified as stage III in 30 cases and stage IV in 10 cases. Palliative surgical treatment was the most performed (47.5%). Postoperative morbidity was 15% and mortality was 42.5% at one year. Conclusion: Stomach cancer is common in the ward. Most patients consult at the stage of metastasis. Palliative surgery remains the most practical. Postoperative morbidity and mortality is very high.

Stomach cancer burden in China: Epidemiology and prevention

In 2020, stomach cancer was the fifth most commonly diagnosed cancer and the fourth leading cause of cancer-related death worldwide. Due to the relatively huge population base and the poor survival rate, stomach cancer is still a threat in China, and accounts for nearly half of the cases worldwide. Fortunately, in China, the incidence and mortality rates of stomach cancer presented a declining trend owing to the change of individual life styles and the persistent efforts to prevent stomach cancer from the governments at all levels. Helicobacter pylori(H. pylori)infection, poor eating habits, smoking, history of gastrointestinal disorders, and family history of stomach cancer are the main risk factors for stomach cancer in China. As a result, by taking risk factors for stomach cancer into account, specific preventive measures, such as eradicating H. pylori and implementing stomach cancer screening projects, should be taken to better prevent and decrease the burden of stomach cancer.

Gastric Cancer Disparities in the United States: Overcoming the Barriers

In this narrative review, we highlight the disparities in the incidence and mortality of gastric cancer across various racial and ethnic populations in the United States (US). Despite the low and decreasing trend in the incidence of gastric cancer in the US, the incidence remains significantly high among Asian and Hispanic Americans, showing a striking racial and ethnic disparity. The low survival rate of gastric cancer further accentuates the magnitude of this disparity. In addition, there is a marked funding disparity among different cancers in the US, reflecting the significantly lower level of support for cancers, such as gastric cancer, which are more prevalent in minority populations, compared to the cancers more prevalent among non-Hispanic Whites (NHW). Moreover, the economic burden from health disparities remains high. Although studies from the US and Asia suggest that screening for stomach cancer may be cost-effective, there is no currently available guideline for scree-ning high-risk populations in the US. A multidimensional framework involving the community, physicians, and policymakers is proposed to tackle these gastric cancer disparities and to develop population-based screening and surveillance programs to reduce the burden of gastric cancer.

Incidence and mortality of stomach cancer in China,2014

Objective： In this study,we aimed to estimate the updated incidence and mortality rate of stomach cancer based on the cancer registration data in 2014,collected by the National Central Cancer Registry of China（NCCRC）.Methods： In 2017,339 registries＇ data were qualified based on the criteria of data quality control of the NCCRC.Cases of stomach cancer were retrieved from the national database.We estimated numbers of stomach cancer cases and deaths in China using age-specific rates and corresponding national population stratified by area,sex,agegroup（0,1–4,5–9,10–14,…,85＋）.Chinese standard population in 2000 and Segi＇s world population were applied for age-standardized incidence and mortality rates.Results： In 2014,410,400 new stomach cancer cases and 293,800 cancer-associated deaths were estimated to have occurred in China.The crude incidence rate of stomach cancer was 30.00/100,000,age-standardized incidence rates by Chinese standard population（ASIRC） and by world standard population（ASIRW） were 19.62/100,000 and19.51/100,000,respectively.The crude mortality rate of stomach cancer was 21.48/100,000,age-standardized mortality rates by Chinese（ASMRC） and by world standard population（ASMRW） were 13.44/100,000 and13.30/100,000,respectively.Incidence and mortality rates in rural areas were both higher than that in urban areas.Stomach cancer has a strong relationship with gender and age.The disease has occurred more frequently among men than women with a male to female ratio of 2.4 for ASIRC.After age group of 40-44 years,incidence rates are substantially higher in men than in women,same pattern was seen for age-specific mortality rates.Conclusions： There is still a heavy burden of stomach cancer in China.The incidence and mortality patterns of stomach cancer show substantial gender and regional disparities.Great effort is needed to provide more accessible health services,sufficient financial resources,and adequate cancer-care infrastructure for the Chinese population,especially for people living in rural areas.

Different cell kinetic changes in rat stomach cancer after treatment with celecoxib or indomethacin: Implications on chemoprevention

AIM: Mechanisms underlying the chemopreventive effects of cyclooxygenase (COX) inhibitors remain elusive. We have previously shown that celecoxib but not indomethacin could prevent carcinogen-induced gastric cancer development in Wistar rats. This chemopreventive effect appeared to be independent of COX-2 and prostaglandin (PG) E2 suppression since the lowest PGE2 was obtained in indomethacin group.This study compared the cell kinetic changes in stomachs of rats after treatment with celecoxib (5, 10, 20 mg/(kg·d)) or indomethacin (3 mg/(kg·d)) to gain more insights into the chemopreventive mechanism.METHODS: The apoptosis and proliferation indexes in gastric tumor, adjacent non-cancer tissues and normal gastric tissues were determined. Apoptosis was quantified by apoptotic nuclei counting and TUNEL, whereas proliferation was determined by Ki67 immunostaining.RESULTS: Treatment with either celecoxib or indomethacin inhibited gastric tumor proliferation by more than 65% (P＜0.02). However, celecoxib caused a dose-dependent increase in apoptosis (P＜0.05) which was not seen in indomethacin-treated tumors (P = 0.54). The highest apoptosis to proliferation ratio was seen in tumors treated with celecoxib at 10 mg/(kg·d). Treatment with this dose of celecoxib was associated with the lowest incidence of gastric cancer development.CONCLUSION: Our findings suggest that the difference in chemopreventive effects of indomethacin and celecoxib in this animal model of gastric carcinogenesis is largely due to the differential cell kinetic changes, which does not correlate with the degree of COX-2 and PG suppression.

EPIDEMIC STRENGTH OF CARDIA AND DISTANT STOMACH CANCER IN THE HIGH RISK REGION OF ESOPHAGEAL CANCER AND THEIR IMPLICATION TO EDOSCOPIC SCREENING

Objective： To discuss the epidemic strength of cardia and distant stomach cancers in the high risk region of esophageal cancer along the south Taihang mountain such as in Shexian, Linxian, and Cixian Counties, and to clarify the tasks for the control of upper gastrointestinal tract cancer as a whole in the region. Methods： Comparisons of incidence and mortality rates of esophageal, cardia and stomach cancers were made between Cixian, Linxian and Shexian Counties with reference to detection rates of cancer in situ and precancerous lesions of the three upper gastrointestinal cancers by endoscopic screening. The screening was performed from 1999 through 2004 in the three adjacent counties including a total of 6233 local residents aged 40 to 69 years old. Results： The incidence rates for cardia cancer for the male and female from 2000 through 2004 were 69.9 and 41.5, and the mortality rates were 54.3 and 33.2 respectively in Shexian County. Esophageal, cardia, and stomach cancers constitute about 70～80 percent of all malignant disease by incidence or mortality rates. Endoscopic survey with iodine staining can effectively detect squamous cell precancerous lesions in the esophagus, but the method is inadequate for the detection of adeno precancerous lesions of the cardia and stomach. Conclusion： The south Taihang mountain region is a high risk area not only for esophagus cancer, but also for cardia and stomach cancers. To control upper gastrointestinal tract cancers as a whole in the region, special attention should be paid to the control of cardia and stomach cancers. Presently, to find effective screening methods for detecting cardia and stomach precancerous lesions is especially important.

Epidemiology of stomach cancer

Despite a decline in incidence and mortality during the last decades,stomach cancer is one of the main health challenges worldwide.According to the GLOBOCAN 2020 estimates,stomach cancer caused approximately 800000 deaths(accounting for 7.7%of all cancer deaths),and ranks as the fourth leading cause of cancer deaths in both genders combined.About 1.1 million new cases of stomach cancer were diagnosed in 2020(accounting for 5.6%of all cancer cases).About 75%of all new cases and all deaths from stomach cancer are reported in Asia.Stomach cancer is one of the most lethal malignant tumors,with a five-year survival rate of around 20%.There are some well-established risk factors for stomach cancer:Helicobacter pylori infection,dietary factors,tobacco,obesity,and radiation.To date,the most important way of preventing stomach cancer is reduced exposure to risk factors,as well as screening and early detection.Further research on risk factors can help identify various opportunities for more effective prevention.Screening programs for stomach cancer have been implemented in a few countries,either as a national or opportunistic screening of high-risk individuals only.Generally,due to its high aggressiveness and heterogeneity,stomach cancer still remains a severe global health problem.

Review of salt consumption and stomach cancer risk:Epidemiological and biological evidence

Stomach cancer is still the fourth most common cancer;thus,it remains an important public health burden worldwide,especially in developing countries.The remarkable geographic variations in the rates of stomach cancer indicate that dietary factors,including a range of food groups to which salt and/or nitrates have been added,may affect stomach cancer risk.In this paper,we review the results from ecologic,case-control and cohort studies on the relationship between salt or salted foods and stomach cancer risk.The majority of ecological studies indicated that the average salt intake in each population was closely correlated with gastric cancer mortality.Most case-control studies showed similar results,indicating a moderate to high increase in risk for the highest level of salt or salted food consumption.The overall results from cohort studies are not totally consistent,but are suggestive of a moderate direct association.Since salt intake has been correlated with Helicobacter pylori(H pylori) infection,it is possible that these two factors may synergize to promote the development of stomach cancer.Additionally,salt may also cause stomach cancer through directly damaging gastric mucus,improving temporary epithelial proliferation and the incidence of endogenous mutations,and inducing hypergastrinemia that leads to eventual parietal cell loss and progression to gastric cancer.Based on the considerable evidence from ecological,case-control and cohort studies worldwide and the mechanistic plausibility,limitation on salt and salted food consumption is a practical strategy for preventing gastric cancer.

Self-expandable metallic stents for palliation of patients with malignant gastric outlet obstruction caused by stomach cancer

AIM: To ascertain clinical outcome and complications of self-expandable metal stents for endoscopic palliation of patients with malignant obstruction of the gastrointestinal (GI) tract. METHODS: A retrospective review was performed throughout August 2000 to June 2005 of 53 patients with gastric outlet obstruction caused by stomach cancer. All patients had symptomatic obstruction including nausea, vomiting, and decreased oral intake. All received self-expandable metallic stents. RESULTS: Stent implantation was successful in all 53 (100%) patients. Relief of obstructive symptoms was achieved in 43 (81.1%) patients. No immediate stent-related complications were noted. Seventeen patients had recurrent obstruction (tumor ingrowth in 14 patients, tumor overgrowth in 1 patient, and partial distal stent migration in 2 patients). The mean survival was 145 d. Median stent patency time was 187 d. CONCLUSION: Endoscopic placement of self-expandable metallic stents is a safe and effective treatment for the palliation of patients with inoperable malignant gastric outlet obstruction caused by stomach cancer.

A study protocol of population-based cancer screening cohort study on esophageal,stomach and liver cancer in rural China

Objective:National Health Commission of the People's Republic of China collaborated with many ministries and commissions government and initiated a population-based cancer screening program in high-risk area of rural China,targeting three types of cancer that are most prevalent in these areas,including esophageal,stomach and liver cancer.This study protocol was reported to show the design and evaluate the effectiveness of cancer screening and appropriate screening strategies of three cancers in rural China.Methods and analysis:A two-step design with cancer risk assessment based on questionnaire interview,Hepatitis B surface antigen(HBsAg)test strip and subsequent clinical intervention for high-risk populations was adopted&ee of charge at the local hospitals designated in the program.Ethic and dissemination:This study was approved by the Institutional Review Board of Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College.The results will evaluate the effectiveness of cancer screening and appropriate screening strategies in rural China.

Effects of ciglitazone and troglitazone on the proliferation of human stomach cancer cells

AIM:To determine the cytological and molecular effects of peroxisome proliferation-activated receptor(PPAR)-γ and PPAR-γ agonists on stomach cancer cells.METHODS:To determine the proliferation-suppressive effects of troglitazone and ciglitazone,SNU-216 and SNU-668 stomach cancer cells were plated in media containing 40 μmol/L troglitazone and ciglitazone at a density of 1 × 104 cells/well.After 3,5 and 7 d,the cells were counted with a hemocytometer.To assess the appearance of PPAR-γ,a reverse-transcription polymerase chain reaction analysis was performed.On day 7,Western blotting was used to determine the effects of troglitazone and ciglitazone on the expression of p21 and phosphorylated-ERK(pERK) genes.Flow cytometry analysis was used to determine which portion of the cell cycle was delayed when troglitazone was used to suppress cell proliferation.In order to clarify the mechanism underlying the activity of troglitazone,microarray analysis was conducted.RESULTS:PPAR-γ was manifested in both SNU-216 and SNU-668 cells.Ciglitazone and troglitazone suppressed cell growth,and troglitazone was a stronger suppressor of stomach cancer cells than ciglitazone,an inducer of cell cycle arrest in the G1 phase.SNU-668 cells were also determined to be more sensitive to ciglitazone and troglitazone than SNU-216 cells.When troglitazone and ciglitazone were administered to stomach cancer cells,levels of p21 expression were increased,but ERK phosphorylation levels were reduced.When GW9662,an antagonist of PPAR-γ,was applied in conjunction with ciglitazone and troglitazone,the cell growth suppression effect was unaffected.The gene transcription program revealed a variety of alterations as the consequence of troglitazone treatment,and multiple troglitazone-associated pathways were detected.The genes whose expression was increased by troglitazone treatment were associated with cell development,differentiation,signal transmission between cells,and cell adhesion,and were also associated with reductions in cell proliferation,the cell cycle,nuclear metabolism,and phosphorylation.CONCLUSION:Troglitazone and ciglitazone suppress the proliferation of stomach cancer cells via a PPAR-γ-independent pathway.

Environmental Risk Factors for Stomach Cancer in an African Setting about 193 Cases at the CHU Point G in Bamako/Mali

CHU (University Hospital Center) Point G: The department of surgery B is a surgical department of CHU Point G. The department is par excellence a reference department for cases of visceral surgery, cancer surgery, cardiovascular surgery, plastic and endocrinology surgery. As a reminder, the CHU Point G is the largest 3rd level referral hospital in Mali. Aim: To study the environmental risk factors of stomach cancer in the B surgery department of the Point G University Hospital in Bamako. Patients and Methods: We performed a cross-sectional study with retrospective collection from January 2008 to June 2018 (126 months). Results: We have identified 380 cases of digestive cancer, including 193 cases of stomach cancer or 50.79% of digestive cancers. The mean age of the patients was 57.21 ± 13 years. Male sex represented 55% (n = 106). Eating habits were dominated by the consumption of tô with potash (cereal paste) with 64.76% (n = 185). The main methods of preserving meat and fish were curing and smoking with 57.51% (n = 111). Chronic smoking was found in 24.35% (n = 47), alcohol + tobacco consumption in 2.59% (n = 5). The low socio-economic class represented 126 cases or 65.38%. Housewives and cultivators were respectively 37.82% (n = 73) and 227.97% (n = 54). 20.20% (n = 39) had a history of epigastric pain. Epigastralgia was the most common functional sign with 84.5% of cases (n = 169). An epigastric mass was found in 72 patients or 37.3%. Adenocarcinoma represented 97.4% (n = 188). Palliative surgery concerned the majority of our patients with 64.8% of patients (n = 79). The postoperative consequences were simple in 28.57% of cases (n = 28), the postoperative morbidity and mortality were respectively 33.61% (n = 41), and 23.77% (n = 29). The overall survival rate after surgery was 10.81% at 2 years and 2.94% at 5 years. This rate was 58.83% at 2 years and 28.50% at 5 years after curative surgery. Conclusion: The risk factors for stomach cancer are many and varied. Some are particularly present in Africa. Delay in diagnosis due to a belief in traditional healers is common in our community.

A NEW FUNCTIONAL CLASSIFICATION OF STOMACH CANCER AND ITS PATHOBIOLOGICAL AND CLINICAL SIGNIFICANCE

The functional differentiations of stomach cancer specimens from 121 patients were investigated by enzyme-,mucin-,affinity-and immunohistochemical methods, and the stomach cancers were divided into five functionally differentiated types : 1 ) Absorptive Function Differentiation Type (AFDT), 19. 8% ; 2) Mucin Secreting Function Differentiation Type(MSFDT) , 24. 0% ; 3) Absorptive and Mucin-Producing Function Differentiation Type(AMPFDT) , 47. 1%; 4 ) Special Function Differentiation Type(SFDT) , 0. 8 %; and 5) Non-Function Differentiation Type(NFDT) , 8. 3%. The results indicate that stomach cancer tissues of the same histological type often display differing functional differentiation, and these functionally differentiated types have different invasive and metastatic characteristics. In addition, the functionally differentiated types have particular organic affinities of metastasis and different clinical prognoses. This study suggests that this new functional classification may supplement histological classification. The mechanisms of liver and ovary metastases of stomach cancer are also dis-cussed.

Clinicopathological characteristics of clinical early gastric cancer in the upper-third stomach

AIM: To elucidate the clinicopathological characteristics of clinically early gastric cancer in the upper-third stomach and to clarify treatment precautions.METHODS: A total of 683 patients with clinical early gastric cancer were enrolled in this retrospective study, 128 of whom had gastric cancer in the upper-third stomach(U group). All patients underwent a double contrast barium examination, endoscopy, and computed tomography(CT), and were diagnosed preoperatively based on the findings obtained. The clinicopathological features of these patients were compared with those of patients with gastric cancer in the middle- and lower-third stomach(ML group). We also compared clinicopathological factors between accurate-diagnosis and under-diagnosis groups in order to identify factors affecting the accuracy of a preoperative diagnosis of tumor depth.RESULTS: Patients in the U group were older(P = 0.029), had a higher ratio of males to females(P = 0.015), and had more histologically differentiated tumors(P = 0.007) than patients in the ML group. A clinical under-diagnosis occurred in 57 out of 683 patients(8.3%), and was more frequent in the U group than in the ML group(16.4% vs 6.3%, P < 0.0001). Therefore, the rates of lymph node metastasis and lymphatic invasion were slightly higher in the U group than in the ML group(P = 0.071 and 0.082, respectively). An under-diagnosis was more frequent in histologically undifferentiated tumors(P = 0.094) and in those larger than 4 cm(P = 0.024). The medianfollow-up period after surgery was 56 mo(range, 1-186 mo). Overall, survival and disease-specific survival rates were significantly lower in the U group than in the ML group(P = 0.016 and 0.020, respectively). However, limited operation-related cancer recurrence was not detected in the U group in the present study.CONCLUSION: Clinical early gastric cancer in the upper-third stomach has distinguishable characteristics that increase the risk of a clinical under-diagnosis, especially in patients with larger or undifferentiated tumors.

FACTORS INFLUENCING SERUM PEPSINOGEN LEVELS IN A CHINESE POPULATION AT HIGH RISK OF STOMACH CANCER

The relationships between serum pepsinogen (PG) levels and age, sex, ABO blood type, cigarette smoking and diet were studied among over 3, 000 residents selected at random in an area with high risk of stomach cancer in Shandong Province, China. Males had significantly higher median PG Ⅰ and Ⅱ levels than feamles. PG Ⅰ tended to decrease and PG Ⅱ to rise with age. Subjects with blood type A had a higher PG Ⅱ level than subjects with other blood types. Both PG Ⅰ and Ⅱ levels rose with dally consumption of cigarettes. Alcohol consumption was not related to PG levels. The PG Ⅰ/Ⅱ ratio declined with increasing consumption of sour pancakes, a fermented staple food found to contain N-nitroso compounds and to be a risk factor for stomach cancer in this population.

AN EPIDEMIOLOGICAL EVIDENCE OF MULTISTAGE PROCESS OF STOMACH CANCER

An endoscopic screening examination was conducted in Linqu county, Shandong Province of China, an area with one of the highest rates for stomach cancer (SC) in the world. A total of 3, 433 residents aged 35 64 were enrolled in this survey.Less than 3% of the subjects had normal or superficisl gastritis(SG), 44. 8% had chronic atrophic gastritis(CAG),33.0% had intestinal metaplasia (IM)and 20. 1% had dysplasia (DYS) as the meet advanced gastric lesions in this population. The transition rates from normal to advanced lesions and SC were calculated in overall and different anatomic locations of the stomach. The transition rates were 98. 3% from SG to CAG, 55.1% from CAG to IM, 38. 3% from IM to DYS and 2. 0% from DYS to SC. Tbe transition rates were significantly higher in the angulus and lesser curvature of antrum than other sites, particularly in the sites of the body.Evidences from this study showed that SC may undergo 3050 years' latent period and involves a multistage process.The probability of transition from normal mucosa to SC is dependept on the transition rate of each intermdiate stage of precancerous lesions.

BIOLOGICAL EFFECTS OF TWEEN－80 IN COMBINATION WITH HYPERTHERMIA ON HUMAN STOMACH CANCER CELL LINE BGC－823

Various biological indices were used to observe the effects of Tween-80 in combination with hyperthermia at different temperature (39-43℃) for different period of time (20-100 minutes) on human stomach cell line BGC-823. The results showed that Tween-80obviously reduced the activation energy of BGC-823 cells. Synergistic effect was observed if applied with heat at 39℃ with the increase in temperature and time,the inhibitory effect on the cancer cells was gradually intensified. The lethal rate of BGC-823 cells treated by heat at 41℃ in combination with Tween-80 was around 5.2 times as that treated by hyperthermia alone. The synergistic effect of heat at 41℃ for 100 min. in combination with Tween-80 was equivalent to the effect of 43℃ for 100 min.In other words, the critical temperature for BGC-823 cells was hereby reduced about 2℃. The measurement of membrane mobility, SDH activity etc.also showed that at 41℃ the synergistic effect of hyperthermia in combination with Tween-80 was the best, it exceeding the single effect of these factors in combination and showing effect of multiplication. The synergistic effect of heat at 41℃ in combination with Tween-80 was higher than that of heat at 41℃ in combination with MMC. It also demonstrated that the specific and sustained action on the inhibition of cancer cells did exist. These studies suggested that the synergistic mechanism of Tween-80 and hyperthermia probably was that both of them acted on the cell membrane system. Supported by The National Natural Science Fund of China (No. 3860948)

High scored thyroid storm after stomach cancer perforation: A case report

BACKGROUND Thyroid storm is a life-threatening emergency.Reportedly,the prevalence of thyroid storm is 1%-2%among patients admitted to the hospital for thyrotoxicosis.Burch and Wartofsky(1993)introduced a scoring system using precise clinical criteria to identify thyroid storms.Only 17 cases of thyroid storm with a score>70 points have been reported.Although thyroid storms are uncommon,their clinical findings resemble those of sepsis.CASE SUMMARY A 48-year-old man was referred to the emergency room from a local clinic owing to suspicion of gastric ulcer perforation;medications for hypertension,diabetes mellitus,and hyperthyroidism had been suspended 1 year prior to this visit.We performed an emergency distal gastrectomy with Billroth II anastomosis for gastric cardia cancer perforation,and the patient was referred to the surgical intensive care unit(ICU).On the 2nd d in the ICU,his body temperature(BT)increased to 41.3℃ at 19:00,with the thyroid storm score(90 points)peaking at 18:00(BT;41.2℃,pulse rate;138/min,irritable status).The patient was administered propylthiouracil,intravenous glucocorticoids,acetaminophen,and Lugol’s solution daily.Subsequently,we performed bladder irrigation with cold saline using a Foley catheter and applied a hypothermic blanket to decrease the patient's BT.His vital signs were stable on the 8th day in the ICU.CONCLUSION Thyroid storms are uncommon,with few reports in the literature;however,their clinical findings resemble those of sepsis and require further investigation.Since an untreated thyroid storm results in a high mortality rate,it should be investigated when managing sepsis.

Stomach One-Point Cancer: One Case Report and Literature Review

IntroductionGastric cancer is one of the most common cancers and one of the most frequent causes of cancer deaths worldwide. Early detection and accurate preoperative staging of gastric cancer is essential for planning optimal therapy such as endoscopic mucosal resection or gastric resection and offers the best prognosis. With advanced technology in diagnostic instruments and the mass screening, early gastric cancer has been detected easier. One-point cancer of gastric is a special type of early gastric cancer. Diagnosis of one-point cancer of gastric is important for both the immediate treatment and the prognosis. There is still no consensus on the operation extent and postoperative treatment for patients with one-point cancer of gastric. Learned from previous reports, we know that existed in the superficial layer of the gastric mucosa and the superficial ulcer is one of the important characteristics of one point cancer of gastric. Herein, we report a case of one point cancer of gastric with the appearance of a deep infiltrating ulcer. To the best of our knowledge, no such type of one point cancer of gastric has been reported.

The clinical features of thoracic stomach cancer after surgical treatment for esophageal carcinoma

Objective:Postoperative recurrence of esophageal carcinoma was the main factor that affect the patients' survival and quality of life.This study mainly investigated the clinical features of thoracic stomach cancer (TSC) after surgical treatment for esophageal carcinoma.Methods:We retrospectively reviewed 51 cases of postoperative TSC in our hospital (Henan Province Tumor Hospital,Zhengzhou,China).Results:The 51 (10.97%) of all 465 cases that underwent endoscope after surgical treatment for esophageal carcinoma in our hospital were TSCs.There were 13 cases with complicating anastomotic recurrence.The locations of 46 cases (90.2%) were the same as the primary cancer.The 48 cases were squamous cell carcinomas and 3 cases were adenocarcinomas after esophagectomy for esophageal carcinoma.Endoscopic manifestations were puffiness-infiltrating type at 39.2% (20/51),massive type at 15.7% (8/51),ulcerative type at 7.8% (4/51) and ulcerative infiltrating type at 3.9% (2/51) and stenotic type etc.Conclusion:The incidence of TSC after surgical treatment for esophageal carcinoma is high.The main cause was that the local residual cancer invaded gastric wall.The gastroscopic features of TSC are different from those of gastric cancer.Regular review with endoscopy in postoperative esophageal carcinoma patients was a major way to diagnose TSC.