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Gastric Cancer as Preventable Disease

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Presentation on theme: "Gastric Cancer as Preventable Disease"— Presentation transcript:

1 Gastric Cancer as Preventable Disease
Massimo Rugge, Robert M. Genta, Francesco Di Mario, Emad M. El-Omar, Hashem B. El-Serag, Matteo Fassan, Richard H. Hunt, Ernst J. Kuipers, Peter Malfertheiner, Kentaro Sugano, David Y. Graham  Clinical Gastroenterology and Hepatology  Volume 15, Issue 12, Pages (December 2017) DOI: /j.cgh Copyright © 2017 AGA Institute Terms and Conditions

2 Figure 1 Phenotypes of advanced precancerous lesions in gastric carcinogenesis (normal glands are included as reference). Progressive disarrangement of the glands’ architecture goes along with epithelial dedifferentiation; unrestricted mitotic activity is seen from the basal portion of the glands until the superficial epithelial layer. The most advanced step of the early neoplastic cascade shows the interruption of the basal membrane, which allows the neoplastic epithelia spreading into the lamina propria (in red the muscularis mucosae). Clinical Gastroenterology and Hepatology  , DOI: ( /j.cgh ) Copyright © 2017 AGA Institute Terms and Conditions

3 Figure 2 Representative examples of endoscopic/histologic appearance of non-atrophic (A) and atrophic intestinalized antral mucosa (B) (endoscopic images obtained with EG-L600ZW: Fuji Film, Tokyo, Japan; original magnification of the histology pictures, ×20). The intestinalized pits are decorated with thin, light blue-colored rims (ie, so-called light blue crests). The light blue crest sign was originally described by Uedo et al66 by applying narrow band imaging with magnification; it can be also observed by blue laser imaging ([BLI]). BLI is a new endoscopic technology enabling image enhancement by applying 2 laser light sources.67 By allowing wider observation of gastric mucosa, BLI enables more consistent assessment of the intestinal metaplasia location/extension. Clinical Gastroenterology and Hepatology  , DOI: ( /j.cgh ) Copyright © 2017 AGA Institute Terms and Conditions

4 Figure 3 Triggers and most deregulated molecular pathways involved during H pylori gastric carcinogenesis. A mixture of bacterial-related, host genetic, and environmental factors determines the beginning of the process of gastric mucosa transformation, which is further sustained by the deregulation of a complex network of molecular pathways. COX-2, cyclooxygenase-2; IM, intestinal metaplasia; NSAID, nonsteroidal anti-inflammatory drug. Clinical Gastroenterology and Hepatology  , DOI: ( /j.cgh ) Copyright © 2017 AGA Institute Terms and Conditions


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