• Journal of Gastric Cancer
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• v.24 no.1
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• pp.69-88
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• 2024

This review comprehensively examines the diverse spectrum of gastric cancers, focusing on unusual or uncommon histology that presents significant diagnostic and therapeutic challenges. While the predominant form, tubular adenocarcinoma, is well-characterized, this review focuses on lesser-known variants, including papillary adenocarcinoma, micropapillary carcinoma, adenosquamous carcinoma, squamous cell carcinoma (SCC), hepatoid adenocarcinoma, gastric choriocarcinoma, gastric carcinoma with lymphoid stroma, carcinosarcoma, gastroblastoma, parietal cell carcinoma, oncocytic adenocarcinoma, Paneth cell carcinoma, gastric adenocarcinoma of the fundic gland type, undifferentiated carcinoma, and extremely well-differentiated adenocarcinoma. Although these diseases have different nomenclatures characterized by distinct histopathological features, these phenotypes often overlap, making it difficult to draw clear boundaries. Furthermore, the number of cases was limited, and the unique histopathological nature and potential pathogenic mechanisms were not well defined. This review highlights the importance of understanding these rare variants for accurate diagnosis, effective treatment planning, and improving patient outcomes. This review emphasizes the need for ongoing research and case studies to enhance our knowledge of these uncommon forms of gastric cancer, which will ultimately contribute to more effective treatments and better prognostic assessments. This review aimed to broaden the pathological narrative by acknowledging and addressing the intricacies of all cancer types, regardless of their rarity, to advance patient care and improve prognosis.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5619-5625
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• 2012

Gastric carcinoma is a leading cause of cancer death in the world and multi-drug resistance (MDR) is an essential aspect of gastric carcinoma chemotherapy failure. Recent studies have shown that integrin-linked kinase (ILK) is involved in metastasis of human tumors, expression silencing of ILK inhibiting the metastasis of several types of cultured human cancer cells. However, the role and potential mechanism of ILK to reverse the multi-drug resistance in human gastric carcinoma is not fully clear. In this report, we focused on roles of expression silencing of ILK in multi-drug resistance reversal of human gastric carcinoma SGC7901/DDP cells, including increased drug sensitivity to cisplatin, cell apoptosis rates, and intracellular accumulation of Rhodamine-123, and decreased mRNA and protein expression of multi-drug resistance gene (MDR1), multi-drug resistance-associated protein (MRP1), excision repair cross-complementing gene 1 (ERCC1), glutathione S-transferase -${\pi}$ (GST-${\pi}$) and RhoE, and transcriptional activation of AP-1 and NF-${\kappa}B$ in ILK silenced SGC7901/DDP cells. We also found that there was a decreased level of p-Akt and p-ERK. The results indicated that ILK might be used as a potential therapeutic strategy to combat multi-drug resistance through blocking PI3K-Akt and MAPK-ERK pathways in human gastric carcinoma.

• Journal of the Korean Institute of Intelligent Systems
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• v.16 no.3
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• pp.332-337
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• 2006

It has been suggested that the endoscopic color of intramucosal gastric carcinoma is correlated with mucosal vascularity within the carcinomatous tissue. The development of electronic endoscopy has made it possible to quantitatively measure the mucosal hemoglobin volume, using a hemoglobin index. The aim of this study was to make a software program to calculate the hemoglobin index (IHb) and then investigate whether the mucosal IHb determined from the electronic endoscopic data is a useful marker for evaluating the color of intramucosal gastric carcinoma, in particular with regard to its value for discriminating between the histologic types. The mean values of IHb for the carcinoma (IHb-C) and the mean values of IHb for the surrounding non-cancerous mucosa (IHb-N) were calculated in 75 intestinal-type and 34 diffuse-type gastric carcinomas. Then, we analyzed the ratio of the IHb-C to IHb-N. The mean IHb-C/IHb-N ratio in the intestinal-type carcinoma group was higher than that in the diffuse-type carcinoma group (1.28$\pm$0.19 vs. 0.81$\pm$0.18, respectively, p<0.001). When the cut-off point of the C/N ratio was set at 1.00, the accuracy rate, the sensitivity, the specificity, and the positive and negative predictive values of a C/R ratio below 1.00 for the differential diagnosis of diffuse-type carcinoma from intestinal-type carcinoma were 94.5%, 94.1%, 94.7%, 88.9% and 97.3%, respectively. IHb is useful for quantitative measurement of the endoscopic color in intramucosal gastric carcinoma and the IHb-C/IHb-N ratio would be helpful in distinguishing diffuse-type carcinoma from intestinal-type carcinoma.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3361-3366
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• 2012

Background & Objectives: The most northern and northwestern regions of Iran are at a high risk for gastric cancer. The aim of this study was to assess the general population's awareness about risk factors, symptoms and signs, preventive methods and management of gastric carcinoma in a high prevalence city in the North of Iran. Methods: A cross-sectional population-based telephone survey which was conducted on 3,457 residents of Rasht, the capital city of Guilan Province, to assess their awareness regarding gastric carcinoma. The questionnaires contained demographic data and statements on respondents' knowledge about risk factors, symptoms and signs, prevention and management of gastric cancer which were filled by general practitioners after asking the subjects. Data were analyzed in SPSS14. P<0.05 was considered significant. Results: The mean knowledge score of the respondents was $5.05{\pm}1.37$ regarding risk factors of gastric carcinoma, $4.39{\pm}1.99$ regarding symptoms and signs, $6.0{\pm}1.22$ regarding preventive strategies, and $1.6{\pm}1.16$ regarding management. Totally the mean knowledge level of the respondents toward gastric carcinoma would be $17.1{\pm}3.97$ from the maximum grade of 29. The age group of 45-55 y/o, bachelor degree and higher, physicians and nurses, those who had cancer history in friends or had the history of gastrointestinal diseases showed significantly higher knowledge scores (P=0.001). Conclusion: There is a general lack of awareness of cancer risk factors, symptoms and signs, methods of prevention, and importance of early diagnosis and treatment. Educational programs should be developed to promote adherence to recommended screening guidelines.

• Asian Oncology Nursing
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• v.2 no.1
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• pp.61-71
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• 2002

Gastric Carcinoma is very plentiful and significant disease in Korean community. The reason is that Gastric Carcinoma is not a simply finding disease with unclear symptoms for early detection. Early detection and early medical treatment of a cancer patient is an important instrument of reducing the mortility rate. The purpose of this study is to identify the effect of audiovisual information with videotape infulencing on knowledge and attitude of early detection of gastric carcinoma. The research design was a non-equivalent control group, pre-post test. The subjects of this study were 52 members of D-taxi drivers which was located in Pusan. The subjects were twenty six experimental group and twenty six control group. The experimental group was collected from January 15, 1999 to January 26, 1999. The control group was collected from the research was 28 minutes video program which was turning out the form of documentary on the based practical experience. And also the experimental tool was used measurung instrument which measured a dependent, variable throughout the consulatation of an percentage, average, standard deviation, ${\chi}^2-test$ and t-test using spss/pc program. The result of this research were as follows : 1)" The experimental group which was offered the video program, should be higher in knowledge of early detection of the gastric carcinoma than the control group" was supported. (t= -7.754, p=.000) 2) "The experimental group which was offered the video program, should be higher in attitude of the early detection of the gastric carcinoma than the control group" was supported. (t=-4.321, p=.000) Therefore, in conclusion, this study that the audiovisual information with videotape influencing on knowledge and attitude of early detection of gastric carcionma was very representational experience throughout the video of documentary form on the based practical experience was much effected the change of the knowledge and the attitude regarding to the early detection of the gastric carcinoma was verified.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2521-2526
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• 2015

Objective: The purpose of this study was to evaluate computed tomography (CT) virtual non-contrast (VNC) spectral imaging for gastric carcinoma. Materials and Methods: Fifty-two patients with histologically proven gastric carcinomas underwent gemstone spectral imaging (GSI) including non-contrast and contrast-enhanced hepatic arterial, portal venous, and equilibrium phase acquisitions prior to surgery. VNC arterial phase (VNCa), VNC venous phase (VNCv), and VNC equilibrium phase (VNCe) images were obtained by subtracting iodine from iodine/water images. Images were analyzed with respect to image quality, gastric carcinoma-intragastric water contrast-to-noise ratio (CNR), gastric carcinoma-perigastric fat CNR, serosal invasion, and enlarged lymph nodes around the lesions. Results: Carcinoma-water CNR values were significantly higher in VNCa, VNCv, and VNCe images than in normal CT images (2.72, 2.60, 2.61, respectively, vs 2.35, $p{\leq}0.008$). Carcinoma-perigastric fat CNR values were significantly lower in VNCa, VNCv, and VNCe images than in normal CT images (7.63, 7.49, 7.32, respectively, vs 8.48, p< 0.001). There were no significant differences of carcinoma-water CNR and carcinoma-perigastric fat CNR among VNCa, VNCv, and VNCe images. There was no difference in the determination of invasion or enlarged lymph nodes between normal CT and VNCa images. Conclusions: VNC arterial phase images may be a surrogate for conventional non-contrast CT images in gastric carcinoma evaluation.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1419-1422
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• 2014

Objective: To summarize the endoscopic screening findings in high-risk population of esophageal and gastric carcinoma and analyze influential factors related to screening. Methods: In seven selected cities and counties with high incidences of esophageal carcinoma, people at age of 40-69 were set as the target population. Those with gastroscopy contradictions were excluded, and all who were voluntary and willing to comply with the medical requirements were subjected to endoscopic screening and histological examination for esophageal, gastric cardia and gastric carcinoma in accordance with national technical manual for early detection and treatment of cancer. Results: In three years, 36,154 people were screened, and 16,847 (46.60%) cases were found to have precancerous lesions. A total of 875 cases were found to have cancers (2.42%), and among them 739 cases had early stage with an early diagnosis rate is 84.5%. Some 715 patients underwent prompt treatment and the success rate was 81.8%. Conclusions: In a high-risk population of esophageal and gastric carcinoma, it is feasible to implement early detection and treatment by endoscopic screening. Screening can identify potential invasive carcinoma, early stage carcinoma and precancerous lesions, improving efficacy through early detection and treatment. The exploratory analysis of related influential factors will help broad implementation of early detection and treatment for esophageal and gastric carcinoma.

• Journal of Digestive Cancer Research
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• v.3 no.1
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• pp.26-29
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• 2015

A 73-year-old male visited our hospital with a complaint of general weakness. He underwent pyloric preserving pancreas-toduodenectomy due to ampullary cancer three years ago. Abdominal computed tomography scan at initial visit revealed multiple hepatic masses. A PET-CT scan showed multiple FDG uptakes at whole liver. He underwent hepatic artery infusion chemotherapy (HAIC) for five cycles. During the first cycle of HAIC, he developed gastric ulcer bleeding and endoscopic hemostasis was done successfully. Esophagogastroduodenoscopy after the 5^th cycle of HAIC revealed ulcer scar at gastric angle. PET-CT scan at 12 months showed no FDG uptake at liver, but a focal FDG uptakes at stomach and peri-gastric lymph nodes were newly developed. Esophagogastroduodenoscopy revealed about 3 cm sized mass at gastric angle. He underwent surgery and pathologic examination revealed large cell neuroendocrine carcinoma. We report a case of gastric large cell neuroendocrine carcinoma with liver metastasis treated with HAIC followed by surgery.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.4
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• pp.335-336
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• 2007

Meniscus-like presentation of ulcerating gastric carcinoma on upper gastrointestinal series radiograph was first described in 1921 by Carman and has since been known as a useful differential diagnostic sign in radiology. In 1982 using then newly introduced computed tomography (CT) Widder and Mueller revisited the meniscus sign. Their study was primarily focused on a dynamic assessment of the demonstrability of the meniscus sign that largely depends on the judgment and technical skill of examiner, especially graded compression and patient positioning. One year earlier Balfe et al. assessed the diagnostic reliability of gastric wall thickening as observed on CT scan in adenocarcinoma, lymphoma and leiomyosarcoma and concluded that it is not a reliable finding. In contrast, however, Lee et al. recently emphasized that the wall thickness measurement on CT of exophytic carcinoma, myoma and ulcers was a useful diagnostic means. Thus, it appears that gastric wall thickening or mucosal heave-up is by itself not as reliable as the meniscus sign. The electronic search of world literature failed to disclose earlier report of this sign demonstrated by $^{18}F-FDG$ positron emission tomography and computed tomography (PET/CT). The present communication documents $^{18}F-FDG$ PET/CT finding of the meniscus sign as encountered in a case of ulcerating gastric carcinoma, the histological diagnosis of which was moderately differentiated tubular adenocarcinoma. Unlike most gastric tumors without ulceration that tend to unimpressively accumulate $^{18}F-FDG$ the present case of Borrmann type III gastric carcinoma demonstrated markedly increased $^{18}F-FDG$ uptake.

• Journal of Gastric Cancer
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• v.1 no.2
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• pp.100-105
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• 2001

Purpose: In the UICC staging system, stage IV contains not only those patients with distant metastasis but also patients with far advanced T and N status but without distant metastasis. We investigated the prognostic factors of stage IV gastric carcinoma patients without distant metastasis after curative resection. Materials and Methods: 190 stage IV gastric carcinoma patients without distant metastasis were reviewed after curative resection. Results: Male sex, distal third location, Borrmann type III, IV and histologically undifferentiated type were common. 5 year survival rate of the 190 patients was $22.2\%$. Depth of invasion and lymph node metastasis did not influence survival. The lymph node ratio (positive lymph node / retrieved lymph node) and combined resection affected survival by univariate and multivariate analysis. Conclusion: Combined resection and positive lymph node ratio were the independent prognostic factors in the patients with stage IV gastric carcinoma who underwent curative resection.