Gastroenterology

Gastroenterology

Volume 129, Issue 3, September 2005, Pages 1079-1082
Gastroenterology

New concepts in Gastroenterology
Inflammation, Atrophy, Gastric Cancer: Connecting the Molecular Dots

https://doi.org/10.1053/j.gastro.2005.07.038Get rights and content

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Location, Location, Location

About 60% to 80% of intestinal-type cancers arise from the gastric antrum with a preference for the lesser curvature. The gastric epithelium is not homogenous but, in fact, is divided into 3 distinct regions, the (upper) cardia, (middle) corpus, and (lower) antrum, with the transitional zone from the oxyntic to antral glands occurring at the incisura. Although many older cancer registries did not distinguish between these locations, it has become more apparent that classification of the cancer

Environmental Triggers: Inflammation Versus Bacteria

The dramatic decline in gastric cancer during the past century correlating with improvements in food storage has placed the etiologic focus squarely on environmental factors.1, 9 Ingestion of a high-salt diet, smoked foods rich in nitrates, and contaminated water teeming with H pylori appear to be the major environmental inducers of gastric cancer, but for different reasons. High salt disrupts the gastric mucosal barrier,9 while N-nitroso mutagens formed from dietary nitrates by bacteria

Connecting the Molecular Dots

Numerous genes have already been implicated in gastric transformation. However, an essential question that emerges is how to organize the known alterations into a temporal sequence of events. The earliest alterations in the gastric mucosa invariably involve epigenetic changes, eg, hypermethylation.12 Although the mechanism by which inflammation stimulates DNA methyltransferases has not been widely pursued, apparently nitric oxide can stimulate the activity of these enzymes that in turn mediate

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Grants R01-DK45729, R01-DK61410, and P01-DK062041 from the National Institutes of Health provided funding. I would like to thank Linda Samuelson and Weiqun Kang for helpful comments.

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