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Review
. 2010 Dec;24(4):853-69, vii.
doi: 10.1016/j.idc.2010.07.010.

Gastric cancer: an infectious disease

M Blanca Piazuelo  1 , Meira Epplein, Pelayo Correa
Affiliations
Review

Gastric cancer: an infectious disease

M Blanca Piazuelo et al. Infect Dis Clin North Am. 2010 Dec.

Abstract

The role of infectious agents and chronic inflammation in carcinogenesis is being increasingly recognized. It has been estimated that about 18% of cancers are directly linked to infections, particularly gastric adenocarcinoma (Helicobacter pylori), cervical carcinoma (human papilloma viruses), and hepatocarcinoma (hepatitis B and C viruses). Multiple clinical trials of COX-2 inhibitors and other antiinflammatory agents have shown a beneficial effect on the development of diverse tumors, such as those of the colon, stomach, prostate, and breast. However, their mechanism of action is not completely understood and may differ among the infectious agents and tumor types. Because gastric adenocarcinomas account for more than 90% of all gastric malignancies, this review focuses on adenocarcinomas.

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Figures

Figure 1
Figure 1
Incidence of stomach cancer in males, worldwide (age-standardized rates). GLOBOCAN, 2000 (http://www-dep.iarc.fr/).
Figure 2
Figure 2
Microphotograph of gastric mucosa colonized by abundant H. pylori organisms (modified Steiner silver stain, ×400).
Figure 3
Figure 3
Microphotographs of gastric adenocarcinoma. A) Intestinal type, showing tumor cells cohesively arranged forming irregular glandular structures. On the left lower corner there are few glands with intestinal metaplasia. An arrow shows the transition zone between intestinal metaplasia and adenocarcinoma (×100). B) Diffuse type, with tumor cells that show lack of cohesiveness infiltrating diffusely. In this subtype, the signet-ring adenocarcinoma, the nuclei are pushed to the periphery due to the abundant mucinous cytoplasmic content (×400).
Figure 4
Figure 4
Model of sequential steps in the gastric precancerous process. Adapted from Correa P., et al. [83].
See this image and copyright information in PMC

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