Possible association of active gastritis, featuring accelerated cell turnover and p53 overexpression, with cancer development at anastomoses after gastrojejunostomy. Comparison with gastroduodenostomy.

Abstract

To cast light on tumorigenesis in the remnant stomach after distal gastrectomy for peptic ulcer or gastric cancer, 45 cases in gastroduodenostomy (Billroth I, 17 cases) and gastrojejunostomy (Billroth II, 28 cases) groups were compared for a series of parameters. Cancers in Billroth II were significantly more predominant in the anastomosis area and more frequently associated with Epstein-Barr virus infection. Active gastritis, accelerated epithelial cell turnover (as assessed by measurements of apoptosis and cell proliferation), DNA damage, and foveolar cell hyperplasia were all greater in anastomotic areas after Billroth II than in proximal areas after Billroth II or either area after Billroth I. K-ras mutations were rare, but Epstein-Barr virus infection in cancers was seen frequently in anastomosis cases. In conclusion, active gastritis, possibly induced by enterogastric reflux, is linked to tumorigenesis in anastomosis sites in Billroth II cases.

• Authors: H Tanigawa, H Uesugi, H Mitomi, K Saigenji, I Okayasu
• Journal: American journal of clinical pathology (Am J Clin Pathol) Vol. 114 Issue 3 Pg. 354-63 (Sep 2000) ISSN: 0002-9173 [Print] England
• PMID: 10989635 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Epstein-Barr virus encoded RNA 1
• Ki-67 Antigen
• RNA, Viral
• Tumor Suppressor Protein p53

Topics

• Adult
• Aged
• Aged, 80 and over
• Apoptosis
• Carcinoma (etiology, metabolism, pathology, virology)
• Cell Division
• Duodenostomy
• Epstein-Barr Virus Infections (complications, pathology)
• Female
• Gastric Mucosa (pathology)
• Gastric Stump (pathology)
• Gastritis (complications, metabolism, pathology, virology)
• Gastroenterostomy (adverse effects)
• Genes, ras
• Helicobacter pylori (isolation & purification)
• Herpesvirus 1, Human (genetics, isolation & purification)
• Humans
• Jejunum (surgery)
• Ki-67 Antigen (analysis)
• Male
• Middle Aged
• RNA, Viral (analysis)
• Stomach Neoplasms (etiology, metabolism, pathology, virology)
• Tumor Suppressor Protein p53 (metabolism)