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pernicious anemia and gastric cancer

Marino Venerito, Alexander Link, Theodoros Rokkas, Peter Malfertheiner
Gastric cancer (GC) ranks fifth for cancer incidence and second for cancer deaths. Epidemiological data showed that survivors of Hodgkin's lymphoma and patients with pernicious anemia etiologically linked to autoimmune gastritis are at increased risk of GC. Screening of patients with autoimmune thyroid disease by means of pepsinogen (PG) I and PG I/II detected autoimmune gastritis with oxyntic gastric atrophy in one of four patients and may be recommended for GC prevention purposes. The International Agency for Research on Cancer reported a positive association between consumption of processed meet and increased GC risk...
September 2016: Helicobacter
Yanna Ko, James Tang, Santosh Sanagapalli, Bong Sik Matthew Kim, Rupert W Leong
INTRODUCTION: Despite being an overall safe drug, several long-term adverse effects are associated with proton pump inhibitors (PPIs). The link between PPI use and gastric neuroendocrine tumors (NETs), gastric adenocarcinomas and Barrett's esophagus progression gastric cancers has been investigated due to PPI-induced hypergastrinemia. AREAS COVERED: The pathophysiological mechanisms underlying PPI exposure and gastric NETs, gastric adenocarcinomas and Barrett's esophagus progression are discussed...
January 2016: Expert Opinion on Drug Safety
Gwen Murphy, Sanford M Dawsey, Eric A Engels, Winnie Ricker, Ruth Parsons, Arash Etemadi, Shih-Wen Lin, Christian C Abnet, Neal D Freedman
BACKGROUND & AIMS: Pernicious anemia, a result of autoimmune gastritis, is the most common cause of vitamin B12 deficiency, affecting 2% to 5% of the elderly population. Treatment with vitamin B12 cures the anemia, but not the gastritis. Findings from small studies have indicated that patients with pernicious anemia could have an increased risk of cancer. METHODS: We performed a population-based, case-control study of individuals in the Surveillance, Epidemiology, and End Results-Medicare database, comparing 1,138,390 cancer cases (age, 66-99 y) with 100,000 matched individuals without cancer (controls)...
December 2015: Clinical Gastroenterology and Hepatology
Malcolm Boyce, Liv Thomsen
OBJECTIVE: Gastric carcinoids (neuroendocrine tumors) arise from enterochromaffin-like cells in the gastric mucosa. Most are caused by hypergastrinemia. The objectives were to determine if their prevalence in Europe, USA and Japan meets the criteria for an orphan disease and to justify treatment with a gastrin/CCK2 receptor antagonist. METHODS: We obtained data from European and USA cancer registries, and searched PubMed. RESULTS: Prevalence per 10,000 population obtained from cancer registries was: median 0...
May 2015: Scandinavian Journal of Gastroenterology
Francesco Cicone, Annalisa Papa, Chiara Lauri, Anna Tofani, Camilla Virili, Marco Centanni, Francesco Scopinaro, Bruno Annibale
Thyro-gastric autoimmunity has not been previously evaluated in patients with differentiated thyroid cancer (DTC), although its long-term complications may be relevant for the management of DTC patients. We assessed the prevalence of gastric autoimmunity and autoimmune gastritis (AG) in patients with Hashimoto's thyroiditis (HT) and concomitant DTC. Prevalence of parietal cell antibody (PCA) positivity, iron deficiency anemia (IDA), and pernicious anemia (PA) were prospectively assessed in 150 DTC patients referred for radioiodine ablation after total thyroidectomy...
May 2015: Endocrine
Edith Lahner, Gianluca Esposito, Emanuela Pilozzi, Gloria Galli, Vito D Corleto, Emilio Di Giulio, Bruno Annibale
BACKGROUND: Atrophic body gastritis (ABG) is associated with both type I gastric carcinoids (T1-GCs) and intestinal-type gastric cancer. The occurrence of gastric cancer in ABG patients with type I gastric carcinoids has not yet been described. AIM: To describe the occurrence at follow-up of gastric cancer in ABG patients with type I gastric carcinoid in a retrospective case series in a single tertiary referral center. METHODS: Between 1994 and 2012, 17 new cases of T1-GCs were diagnosed among a cohort of ABG patients in a single tertiary referral center for ABG...
July 2015: Gastric Cancer
Nicola Bizzaro, Antonio Antico
Pernicious anemia (PA) is a complex disorder consisting of hematological, gastric and immunological alterations. Diagnosis of PA relies on histologically proven atrophic body gastritis, peripheral blood examination showing megaloblastic anemia with hypersegmented neutrophils, cobalamin deficiency and antibodies to intrinsic factor and to gastric parietal cells. Anti-parietal cell antibodies are found in 90% of patients with PA, but have low specificity and are seen in atrophic gastritis without megaloblastic anemia as well as in various autoimmune disorders...
April 2014: Autoimmunity Reviews
Hisayo Nishiura, Satoru Iwamoto, Masahiro Kido, Nobuhiro Aoki, Ryutaro Maruoka, Aki Ikeda, Tsutomu Chiba, Norihiko Watanabe
BACKGROUND AND AIM: Autoimmune gastritis (AIG), an organ-specific autoimmune disease, is accompanied by achlorhydria, pernicious anemia, gastric carcinoid tumors, and gastric cancer. Patients with AIG initially respond to corticosteroids but have a great potential to relapse after treatment is withdrawn. This study examines the roles of cytokines in order to identify potential therapeutic options for AIG patients. METHODS: Using a mouse model of AIG, we monitored disease progression and administered antibodies in vivo to block cytokines...
June 2013: Journal of Gastroenterology and Hepatology
L Vannella, E Lahner, J Osborn, B Annibale
BACKGROUND: Pernicious anaemia (PA) has an increased risk for gastric cancer (GC). It is not established whether PA patients need to undergo endoscopic/histological follow-up. AIM: To provide a systematic overview of the literature on PA and the development of gastric cancer, to estimate the gastric cancer incidence-rate. METHODS: According to PRISMA, we identified studies on PA patients reporting the incidence of gastric cancer. Quality of studies was evaluated using the Newcastle-Ottawa Quality Assessment Scale...
February 2013: Alimentary Pharmacology & Therapeutics
Bruno Annibale, Edith Lahner, Gianfranco Delle Fave
Pernicious anemia is a macrocytic anemia due to cobalamin deficiency, which is the result of intrinsic factor deficiency. Pernicious anemia is associated with atrophic body gastritis, whose diagnostic criteria are based on the histologic evidence of gastric body atrophy associated with hypochlorhydria. Serological markers suggesting the presence of oxyntic mucosa damage are increased levels of fasting gastrin and decreased levels of Pepsinogen I. Without the now obsolete Schilling's test, intrinsic factor deficiency may not be proven, and gastric intrinsic factor output after pentagastric stimulation has been proposed...
December 2011: Current Gastroenterology Reports
F Dhalla, S P da Silva, M Lucas, S Travis, H Chapel
Common variable immunodeficiency disorders (CVIDs) are the most frequent symptomatic primary immunodeficiencies in adults. They comprise a heterogeneous group of pathologies, with frequent non-infectious complications in addition to the bacterial infections that usually characterize their presentation. Complications include a high risk of malignancy, especially lymphoma and gastric cancer. Helicobacter pylori infection and pernicious anaemia are risk predictors for gastric cancer in the general population and probably in patients with CVIDs...
July 2011: Clinical and Experimental Immunology
Emiko Nakao, Atsushi Mitsunaga, Tetsuya Hamano, Miho Shirato, Izumi Shirato, Takayoshi Nishino
A 59-year-old woman was initially thought to have either type A gastritis, or autoimmune gastritis by upper-gastrointestinal-tract endoscopy and a serological examination. Furthermore, the patient was also suspected to have Hashimoto disease based on a positive antithyroid-antibody test. Rheumatoid arthritis was diagnosed 1 year later. Pernicious anemia, gastric-carcinoid and stomach cancer are the primary complications of A type gastritis. However, we hypothesized that the development of other autoimmune diseases, such as autoimmune thyroid disease, was the primary complication experienced in this case...
December 2010: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Guenter J Krejs
The incidence of gastric cancer is decreasing and lies between 10 and 15 new cases per 100,000 population per year in most Western countries. Peak age is between 60 and 80 years. While distal gastric cancers account for the overall decrease in gastric cancer, tumors in the proximal stomach (cardia and esophagogastric junction) are on the rise. Recognized risk factors for gastric cancer are infection with Helicobacter pylori, dietary factors (e.g. high intake of salt-preserved foods), smoking, pernicious anemia and a history of partial gastrectomy...
2010: Digestive Diseases
B Tepes
Gastric adenocarcinoma is the fourth most common malignancy worldwide and is globally the second leading cause of cancer-related deaths each year. Among the risk factors are genetic factors (genetic diffuse gastric cancer - E-cadherin mutation (CDH1), pro- and anti-inflammatory cytokine genes and innate immune response gene polymorphisms), environmental factors (infection with the bacterium Helicobacter pylori (H. pylori), Epstein-Barr virus, nutrition: nitroso compounds, salt and antioxidants intake) and other factors (pernicious anemia, gastric polyps, gastric surgery, reproductive hormones, smoking)...
December 2009: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
I P Häkkinen
Sulphopolysaccharides, isolated from gastric juice of patients with pernicious anemia or gastric cancer, have been characterized immunologically using corresponding rabbit immunosera. Gastric juice sulphopolysaccharides differ from their normal form in the following conditions: a) when there is intestinal type metaplastic tissue in the gastric epithelium; b) in the presence of gastric cancer. Efforts to differentiate between these types by the absorption technique using rabbit immunosera were successful, and it was possible to demonstrate an antigenic determinant in sulphopolysaccharides from cancerous gastric juice not present in controls with benign intestinal type heterotopia as in pernicious anemia...
1967: Scandinavian Journal of Gastroenterology
Jeffrey Copps, Richard F Murphy, Sándor Lovas
The gastrointestinal peptide hormone gastrin is responsible for initiating the release of gastric acid in the stomach in response to the presence of food and/or humoral factors such as gastrin releasing peptide. However, it has a role in the growth and maintenance of the gastric epithelium, and has been implicated in the formation and growth of gastric cancers. Hypergastrinemia resulting from atrophic gastritis and pernicious anemia leads to hyperplasia and carcinoid formation in rats, and contributes to tumor formation in humans...
2009: Protein and Peptide Letters
Edith Lahner, Bruno Annibale
Pernicious anemia (PA) is a macrocytic anemia that is caused by vitamin B(12) deficiency, as a result of intrinsic factor deficiency. PA is associated with atrophic body gastritis (ABG), whose diagnosis is based on histological confirmation of gastric body atrophy. Serological markers that suggest oxyntic mucosa damage are increased fasting gastrin and decreased pepsinogen I. Without performing Schilling's test, intrinsic factor deficiency may not be proven, and intrinsic factor and parietal cell antibodies are useful surrogate markers of PA, with 73% sensitivity and 100% specificity...
November 7, 2009: World Journal of Gastroenterology: WJG
J C W Chan, H S Y Liu, B C S Kho, T K H Lau, V L Li, F H Y Chan, I S Leong, H K Pang, C K Lee, Y S Liang
BACKGROUND: The survival of whites who have been treated for pernicious anaemia (PA) is unaffected, apart from incurring a greater risk of gastric cancers. The long term outcome of PA in Chinese is unknown. METHODS: A hospital based prospective longitudinal study of Chinese PA patients was conducted. Patients with known cancers were excluded. RESULTS: From 1994 to 2007, 199 intrinsic factor antibody (IFA) positive and 168 IFA negative patients were recruited...
December 2008: Postgraduate Medical Journal
A Neesse, P Michl, P Barth, M Vieth, P Langer, V Ellenrieder, T M Gress
Autoimmune atrophic gastritis (AMAG) is characterised by the presence of parietal cell antibodies (PCA) and occurs in the gastric corpus. Pernicious anaemia (PA) is regarded as the most distinct feature and sequela of AMAG and is associated with the presence of PCA in about 60 - 90 % of cases. AMAG is considered as an independent risk factor for the development of gastric cancer. Interestingly, the risk to progress from metaplasia to neoplasia and ultimately invasive cancer has exclusively been described in patients with PA...
February 2009: Zeitschrift Für Gastroenterologie
Hala El-Zimaity
PURPOSE OF REVIEW: The majority of problems in interpreting gastritis remain Helicobacter related, but their nature has changed. The present review covers gastritis historically through cancer risk staging systems. RECENT FINDINGS: Key points to remember are: Helicobacter is associated with several forms of gastritis; in the present review, I am focusing on the two ends of the disease, 'Helicobacter pylori infection', that starts with antral predominant gastritis but can continue to oxyntic predominant disease with atrophy; the role Helicobacter pylori plays in autoimmune gastritis with pernicious anemia remains unresolved; gastritis staging systems for cancer risk, namely Baylor and Operative Link on Gastritis Assessment, are currently available...
November 2008: Current Opinion in Gastroenterology
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