Gastroenterostoma after Billroth antrectomy as a premalignant condition  

作　　者：Robert Sitarz Ryszard Maciejewski Wojciech P Polkowski G Johan A Offerhaus 

机构地区：[1]Department of Pathology,University Medical Centre,Utrecht,3584 CX Utrecht,The Netherlands [2]Department of Human Anatomy,Medical University of Lublin,20-950 Lublin,Poland [3]Department of Surgical Oncology,Medical University of Lublin,20-081 Lublin,Poland [4]Department of Pathology, Academic Medical Centre, 1105 AZ Amsterdam, The Netherlands

出　　处：《World Journal of Gastroenterology》2012年第25期3201-3206,共6页世界胃肠病学杂志（英文版）

基　　金：Supported by An EMBO fellowship to SitarzR

摘　　要：Gastric stump carcinoma （GSC） following remote gastric surgery is widely recognized as a separate entity within the group of various types of gastric cancer. Gastrecto- my is a well established risk factor for the development of GSC at a long time after the initial surgery. Both exo- as well as endogenous factors appear to be involved in the etiopathogenesis of GSC, such as achlorhydria, hypergastrinemia and biliary reflux, Epstein-Barr virus and Helicobacter pylori infection, atrophic gastritis, and also some polymorphisms in interleukin-l~ and maybe cyclo-oxygenase-2. This review summarizes the litera- ture of GSC, with special reference to reliable early di- agnostics. In particular, dysplasia can be considered as a dependable morphological marker. Therefore, close endoscopic surveillance with multiple biopsies of the gastroenterostomy is recommended. Screening start- ing at 15 years after the initial ulcer surgery can detect tumors at a curable stage. This approach can be ofspecial interest in Eastern European countries, where surgery for benign gastroduodenal ulcers has remained a practice for a much longer time than in Western Eu- rope, and therefore GSC is found with higher frequency.Gastric stump carcinoma(GSC) following remote gastric surgery is widely recognized as a separate entity within the group of various types of gastric cancer.Gastrectomy is a well established risk factor for the development of GSC at a long time after the initial surgery.Both exoas well as endogenous factors appear to be involved in the etiopathogenesis of GSC,such as achlorhydria,hypergastrinemia and biliary reflux,Epstein-Barr virus and Helicobacter pylori infection,atrophic gastritis,and also some polymorphisms in interleukin-1 and maybe cyclo-oxygenase-2.This review summarizes the literature of GSC,with special reference to reliable early diagnostics.In particular,dysplasia can be considered as a dependable morphological marker.Therefore,close endoscopic surveillance with multiple biopsies of the gastroenterostomy is recommended.Screening starting at 15 years after the initial ulcer surgery can detect tumors at a curable stage.This approach can be ofspecial interest in Eastern European countries,where surgery for benign gastroduodenal ulcers has remained a practice for a much longer time than in Western Europe,and therefore GSC is found with higher frequency.

关 键 词：Gastric stump cancer GASTRECTOMY RISKFACTORS Endoscopic surveillance 

分 类 号：R735.2[医药卫生—肿瘤]