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Introduction and aims: Epstein-Barr virus (EBV) infection is an etiologic factor in EBV-associated gastric carcinoma (EBVaGC). The aim of our study was to describe the clinical and histopathologic characteristics of EBV infection in intestinal-type gastric adenocarcinoma samples. Material and methods: Of 180 paraffin-embedded gastrectomy samples, 28 were studied. Chromogenic in situ hybridization was performed to detect EBV. Sociodemographic and histopathologic data were obtained from the patients’ clinical histories. Results: A total of 21.4% of the samples were positive for EBV. The predominant morphologic characteristic was the lace pattern, with dense inflammatory infiltration. Fifty percent of the EBVaGC+ patients were men, and the median age of the positive patients was 59 years (range: 50–75); 77.2% of the EBVaGC− patients were men, and the median age of the negative patients was 66 years (range: 34–89). Helicobacter pylori infection was associated with 10.7% of the EBVaGC+ patients and 53.6% of the EBVaGC− patients. In the EBVaGC+ patients, the cardia was the most frequent tumor location (17.9%), 7.1% had histologic grades 2 and 3, and 17.9% presented with Borrmann classification type III. In the EBVaGC− patients, the cardia and fundus were the most frequent tumor locations (71.4%), 35.7% had histologic grade 2, and 39.3% and 21.4% presented with Borrmann classification type III and IV, respectively. Conclusions: The present study describes the clinical and histopathologic characteristics associated with EBVaGC positivity. Those data may aid in the selection of cases that are candidates for analysis through molecular methods aimed at identifying EBV infection in intestinal-type gastric adenocarcinoma. Resumen: Introducción y objetivos: La infección por virus de Epstein-Barr (VEB) es un factor etiológico de un subgrupo de cáncer gástrico (CaGVEB). El objetivo del estudio fue caracterizar la clínico-histopatología de la infección por VEB en muestras de adenocarcinoma gástrico de tipo intestinal. Material y métodos: 28 de 180 muestras de gastrectomías parafinizadas fueron estudiadas, se realizó hibridación in situ cromogénica para reconocimiento del VEB. Se obtuvieron datos sociodemográficos e histopatológicos de historias clínicas. Resultados: 21.4% de las muestras fueron positivas para VEB. La característica morfológica predominante fue patrón en encaje con denso infiltrado inflamatorio. De los pacientes CaGVEB+ 50% eran hombres, mediana de edad 59 años (rango 50–75), y de los CaGVEB−, 77.2% eran hombres, mediana de edad 66 años (rango 34–89). 10.7% de los CaGVEB+ y 53.6% de los CaGVEB− se asociaron a infección por Helicobacter pylori. Entre los CaGVEB+, la localización del tumor más frecuente fue cardias (17.9%) y entre los CaGVEB− fue cardias y fondo (71.4%). En la clasificación según grado histológico, los CaGVEB+ se asociaron a grados 2 y 3 (7.1%), y los CaGVEB- a grado 2 (35.7%). Para la clasificación Borrmann, 17.9% de los CaGVEB+ presentaron clasificación III, mientras que 39.3% y 21.4% de CaGVEB− presentaron clasificación III y IV, respectivamente. Conclusiones: Este estudio presenta características clínico-histopatológicas asociadas a CaGVEB+ que pueden contribuir con la selección de casos candidatos a ser estudiados por métodos moleculares dirigidos a la identificación de la infección por virus de Epstein-Barr en adenocarcinoma gástrico de tipo intestinal.

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Objetivo: El tumor de Krukenberg se define como un adenocarcinoma metástasico al ovario que contenga células en anillo de sello productoras de mucina. El 70 a 90% de los adenocarcinoma mucosecretores que causan el tumor de Krukenberg se originan en la mucosa gástrica como lo es el siguiente caso a presentar, de femenino con 35 años que manifiesta primeramente síntomas gastrointestinales. Siendo el 30% de los casos de este tumor como manifestación primaria. Suele presentarse a una edad promedio de 45 años o menos y el 80% de los casos suele ser bilateral, además de que la localización del primario se desconoce en el 40% los casos. Los tumores de Krukenberg se asocian con un mal pronóstico; por lo tanto, examen ginecológico regular en pacientes femeninas con antecedentes de cáncer gástrico es muy importante para el diagnóstico precoz y tratamiento de esta enfermedad. Conclusión: El diagnóstico de esta patología requiere una evaluación anatomopatológica exhaustiva, con el fin de no dar falsas expectativas a la paciente con un diagnóstico benigno o menos agresivo que el de tumor de Krukenberg. Los pacientes generalmente fallecenen 2 años. La mediana de supervivencia global de los pacientes con tumor de Krukenberg es de 11 - 19 meses para aquellos tumores de origen gástrico.

Introducción: el cáncer gástrico, a nivel mundial, tiene una incidencia variable y es una de las causas más frecuentes de muerte. En Ecuador ocupa el segundo lugar de muerte en los hombres y la cuarta en las mujeres por cáncer gástrico. Objetivos: establecer las características sociodemográficas, clínicas, histológicas y endoscópicas, y determinar una correlación entre la localización e histología en una población de pacientes con cáncer gástrico en el Hospital de Especialidades de Guayaquil, Dr. Abel Gilbert Pontón. Materiales y métodos: estudio de prevalencia analítico y prospectivo. Se incluyeron las endoscopias digestivas altas de consulta externa y emergencia con signos de sospecha de cáncer gástrico realizadas en el Hospital de Especialidades de Guayaquil, Dr. Abel Gilbert Pontón, Ecuador, entre enero de 2018 y diciembre de 2019. Resultados: en el estudio se incluyeron 62 pacientes con diagnóstico de adenocarcinoma gástrico, el sexo masculino representó el 72,6 % en relación con el sexo femenino, con el 27,4 %; el rango de edad fue entre los 27 y 95 años, el promedio de edad es de 60,96 ± 15,1 y la edad de mayor presentación fue de 60 a 70 años. El síntoma que predominó fue el dolor, en un 98,4 %, y la pérdida de peso, en un 64,5 %; su localización más frecuente fue el antro (50,0 %), su morfología de mayor presentación es el Borrmann tipo III y, con respecto al tipo histológico, se encontró el tipo intestinal (64,5 %) y el difuso (29,0 %). El tipo intestinal se presentó en edad más avanzada en un 60 %-69 %, fue más frecuente en el cuerpo (71,4 %) y su localización fue más proximal, en comparación con el tipo difuso, que se presentó más en edad temprana (27-39 años), fue más frecuente en el antro (32,3 %) y su localización fue más distal. Conclusiones: el cáncer gástrico se diagnostica en estadios avanzados, más en hombres que en mujeres y se puede afirmar que en nuestro hospital la localización del cáncer gástrico tipo intestinal se presentó en edades avanzadas, más frecuentemente a nivel proximal y en la clasificación del cáncer gástrico avanzado Borrmann tipo III, lo cual podría tener influencia en el tratamiento y pronóstico. Además, los resultados obtenidos justifican la implementación de programas de detección oportuna y tratamiento de esta grave enfermedad.

Introduction: Gastric cancer is one of the most common causes of death worldwide, with a varying incidence. In Ecuador, it is the second leading cause of death in men and the fourth in women. Objectives: To establish the socio-demographic, clinical, histological, and endoscopic characteristics of patients with gastric cancer and to determine the correlation between location and histology in this population treated at the Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón. Materials and methods: Analytical and prospective prevalence study. Outpatient and emergency upper gastrointestinal endoscopies with signs of suspected gastric cancer performed at the Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón - Ecuador between January 2018 through December 2019 were included. Results: The study included 62 patients diagnosed with gastric adenocarcinoma. 72.6% were male and 27.4% were female; the age range was between 27 and 95 years, with an average of 60.96 ± 15.1 years, the age of onset being between 60 and 70 years. Pain was the most frequent symptom in 98.4% of cases, followed by weight loss in 64.5%. The antrum was the most common site of cancer (50.0%), and Borrmann type III was the most common morphology. Intestinal cancer was found in 64.5% of cases, while diffuse gastric cancer was found in 29.0%. Intestinal cancer was more common in older ages (60-69%) and the most frequent site of presentation was the body of the stomach (71.4%) with a proximal location. In contrast, diffuse gastric cancer was more frequent in younger patients aged between 27-39 years, more often in the antrum (32.3%) at a more distal location. Conclusions: Gastric cancer is more often found in men and is usually diagnosed in advanced stages. Intestinal gastric cancer was most commonly seen at advanced ages in our hospital, most frequently at the proximal site and in the Borrmann type III according to the classification of advanced gastric cancer, affecting its treatment and prognosis. The results obtained support the implementation of programs to diagnose and treat this severe disease in a timely manner. [ABSTRACT FROM AUTHOR]

Abstract: Bone metastasis in gastric cancer is uncommon and usually emerges as a recurrence of cancer and in a later stage of the disease. Therefore, spine metastasis as an initial presentation of gastric adenocarcinoma is a rare event. We present the case of an 82-year-old woman, with a history of prolonged lumbar pain and no gastrointestinal symptoms. A lumbar computed tomography scan identified multiple osteolytic lesions and upon additional investigation we found a Gastric Adenocarcinoma as the primary tumor. She initiated palliative radiotherapy and best supportive care. Resumen: Las metástasis óseas en el cáncer gástrico son poco frecuentes y normalmente se detectan como recurrencia de un tumor o en estadios avanzados de la enfermedad. Por ello, esta forma de presentación en un adenocarcinoma gástrico es infrecuente. Presentamos el caso de una paciente de 82 años con historia de dolor lumbar de larga evolución y ausencia de síntomas gastro-intestinales. Una tomografía lumbar identificó múltiples lesiones osteolíticas y tras estudios complementarios se encontró un adenocarcinoma gástrico como tumor primario. Se inició tratamiento paliativo con radioterapia y de soporte.

El cáncer gástrico conlleva un gran impacto social a nivel mundial por ser una de las primeras causas de muerte por cáncer. Únicamente entre el 1-3 % de los casos se detecta un componente hereditario(5), lo que indica que su origen es mayoritariamente ambiental. El cáncer gástrico tiende a emerger de una gastritis o inflamación crónica subyacente acompañada de hipoclorhidia, la cual suele ser ocasionada por Helicobacter pylori. Ante un estímulo lesivo, el epitelio normal del estómago desarrolla gastritis crónica atrófica que evoluciona a metaplasia y posteriormente a lesiones displásicas(9). La sintomatología suele ser muy inespecífica y el examen físico es normal al inicio. El diagnóstico, entonces, es tardío y se realiza por medio de endoscopía con toma de biopsia(7). El cribado rutinario con gastroscopía no está recomendado a pesar de que los datos epidemiológicos del cáncer gástrico siguen siendo alarmantes(7).

Paraneoplastic pemphigus, an acquired autoimmune mucocutaneous condition of the skin and mucous membranes, is characterized by erythema and painful blistering, concomitant with underlying neoplastic disease. Clinical manifestations may precede, occur concomitantly or present after cancer diagnosis. Specific associated neoplasms are usually hematologic (non- Hodgkin's lymphoma, chronic lymphocytic leukemia, Castleman's disease, thymoma, Waldenström macroglobulinemia), less frequently sarcomas. We present the case of a patient with paraneoplastic pemphigus in whom the clinical presentation preceded the diagnosis of gastric adenocarcinoma. In the medical literature few cases are associated with gastrointestinal neoplasms. [ABSTRACT FROM AUTHOR]

Paraneoplastic pemphigus, an acquired autoimmune mucocutaneous condition of the skin and mucous membranes, is characterized by erythema and painful blistering, concomitant with underlying neoplastic disease. Clinical manifestations may precede, occur concomitantly or present after cancer diagnosis. Specific associated neoplasms are usually hematologic (non- Hodgkin's lymphoma, chronic lymphocytic leukemia, Castleman's disease, thymoma, Waldenström macroglobulinemia), less frequently sarcomas. We present the case of a patient with paraneoplastic pemphigus in whom the clinical presentation preceded the diagnosis of gastric adenocarcinoma. In the medical literature few cases are associated with gastrointestinal neoplasms. [ABSTRACT FROM AUTHOR]

Introducción: La asociación entre Helicobacter pylori y las neoplasias gástricas malignas ha sido ampliamente demostrada, en relación con esto, la OMS determinó que el microorganismo es agente carcinógeno comprobado del grupo I. En México la prevalencia de infección por esta bacteria es alta. Objetivo: Evaluación de la relación entre variables sociodemográficas, clínicoendoscópicas e histopatológicas con los diferentes tipos de neoplasias gástricas malignas en pacientes Helicobacter pylori positivos y negativos. Pacientes y métodos: Se desarrolló una investigación en la región Sur de México, de tipo retrospectiva, descriptiva e inferencial; se estudiaron 214 casos con adenocarcinoma gástrico y linfoma asociado a mucosas (MALT, por sus siglas en inglés), diagnosticados en el período 2001-2011, de los cuales 99 presentaron Helicobacter pylori. Se utilizaron técnicas estadísticas para evaluar la posible relación entre variables. Procedimientos: Media aritmética y desviación estándar, porcentajes y sus errores. Técnicas: Prueba de Chi² para tablas de contingencia, correlación de rango de Spearman, estimación de parámetros poblacionales, comparación de porcentajes relacionados. Resultados: Se encontraron asociaciones significativas entre el diagnóstico histológico y edades, serotipo sanguíneo, antecedente de familiares con cáncer y la sintomatología (dispepsia y signos de alarma). Y asociaciones muy significativas entre la presencia de Helicobacter pylori con vivos, fallecidos y el diagnóstico histológico. Se determinó que el adenocarcinoma difuso aparece entre 48,8% y 62,4% con una probabilidad de 95% en la población con esta característica, igualmente el porcentaje de neoplasia/tumor dentro del diagnóstico endoscópico oscila entre 68,4% y 80,6% con una probabilidad de 95%. El intervalo de confianza con 99% de certeza para la edad en que se manifiestan estas enfermedades se mueve entre 56 y 62 años. Conclusiones: Queda demostrado que las características sociodemográficas, clínicoendoscópicas e histológicas de los pacientes con adenocarcinoma y linfoma MALT influyen en el diagnóstico final, evolución y pronóstico. La presencia de Helicobacter pylori en estos pacientes fue determinante para su sobrevivencia.Introduction:The association between Helicobacter pylori and the gastric malignant has been extensively demonstrated, in relation to this, the WHO determined that the microorganism is a carcinogen agent proved from group I. In Mexico the prevalence of infection by this bacterium it is high Objective: Evaluation of the relationship between the socio-demographic, clinical-endoscopic and histopathological variables with the different kinds of gastric malignant in Helicobacter pylori positive and negative patients. Patients and methods: An investigation was carried out to determine the kind of association in a population of the south region of Mexico. The type of research is retrospective, descriptive and inferential, 214 cases with gastric adenocarcinoma and lymphoma associated to the mucosal (MALT) were studied, they were diagnosed from 2001 to 2011, of which 99 had Helicobacter pylori. Statistical techniques to evaluate the possible relationship between variables were used. Procedures: Arithmetic mean and standard deviation, percentages and its errors. Techniques: Chi square test for contingency tables, correlation of Spearman´s range, population parameter estimation, related percentage comparison. Results: It was found meaningful associations between the histologic diagnostic and ages, blood serotype, antecedent of relatives with cancer and the symptomatology (dyspepsia and alarm signs), and very meaningful association between the presence of Helicobacter pylori with alive, deceased and the histologic diagnostic. It was determined that diffuse adenocarcinoma appears between a 48,8% and 62,4% with a probability of the 95% in the population with this characteristics, likewise, the percentage of neoplasm/toumor within endoscopic diagnosis ranges between 68,4% and 80,6% with a 95% probability. The interval of confidence with the 99% of certainty for the age in which these illnesses appear it moves between 56 and 62 years. Conclusions: It has been proved that the socio-demographic, clinical-endoscopic and histologic characteristics of these patients with adenocarcinoma and lymphoma MALT have an influence in the final diagnostic, evolution and prognostic. The presence of Helicobacter pylori in these patients was determining for their survival.

RACIONAL: A gastrectomia total é considerada um procedimento de alto nível de complexidade, apresenta taxas de complicações elevadas, tanto locais como gerais, pois os doentes na sua maioria estão com as condições clínicas e nutricionais comprometidas pela doença. OBJETIVOS: analisar os resultados imediatos e complicações da gastrectomia total no período de 1972 a 2007. MÉTODOS: Foram revisados os prontuários médicos de 300 doentes portadores de adenocarcinoma gástrico, subdivididos em dois períodos: 1972 a 1992 - compreendendo 108 doentes (36%) e 1993 a 2007 - compreendendo 192 doentes (64%). Eram 67,3% do sexo masculinos, 70,7% brancos e com faixa etária variando de 25 a 86 anos (média de 63,4 anos). As lesões estavam localizadas em cárdia - 40 casos (13,3%); fundo gástrico - 83 casos (27,6%); corpo gástrico - 77 casos (25,6%); linite plástica - 45 casos (15%); côto gástrico - 33 casos (11%) e antro/corpo gástrico - 22 casos (7,3%). A gastrectomia total ampliada com linfadenectomia até nível D2 foi realizada em 246 casos (82%). RESULTADOS: A técnica de reconstrução mais utilizada foi a anastomose esôfago-jejunal término-lateral em Y-Roux em 257 doentes (86,7%). As complicações gerais no período de 1972-92 totalizaram 47 casos (43,5%), compreendendo principalmente as respiratórias (28 casos - 25,9%) e as urinárias (10 casos - 9,2%). No período 1993-2007 totalizaram 48 casos (25%), principalmente complicações respiratórias (27 casos - 14%), seguidas também das urinárias (12 casos - 6,2%). No período de 1972-92 estas complicações locais totalizaram 45 casos (30,8%) e no período de 1993-2007 atingiram 28 casos (14,5%), sendo as fistulas digestivas as mais frequentes. A mortalidade operatória até o 30º dia foi de 18 casos (6%), sendo que no período de 1972-92 totalizou 12 casos (11,1%) e no período de 1993-2007 foi de 7 casos (3,6%). CONCLUSÕES: A gastrectomia total é um procedimento que requer experiência do cirurgião, de sua equipe, empregando técnica cirúrgica aprimorada para minimizar as complicações pós-operatórias. As complicações pós-operatórias requerem cuidados no controle das infecções, das vias aéreas e cuidados nutricionais, diminuindo a mortalidade, aumentando a sobrevida e contribuindo para a qualidade de vida do doente.BACKGROUND: A total gastrectomy is considered a procedure with a high level of complexity, has high complication rates, both local and general, because patients are mostly with clinical conditions and nutritional compromised by disease. AIM: To analyse the results and complications of the total gastrectomy in gastric cancer in the period from 1972 to 2007. METHODS: Were reviewed the medical records of 300 patients with gastric adenocarcinoma, divided into two periods: from 1972 to 1992 - comprising 108 patients (36%) and from 1993 to 2007 - comprising 192 patients (64%). They were 67.3% males, 70.7% whites, with ages ranging from 25 to 86 years (mean 63.4 years). The lesions were located in cardia - 40 cases (13.3%), gastric fundus - 83 cases (27.6%), gastric body - 77 cases (25.6%); plastic linitis- 45 cases (15%); gastric stump - 33 cases (11%) and antrum and body gastric - 22 cases (7.3%). A total gastrectomy with extended lymphadenectomy to level D2 was performed in 246 cases (82%). RESULTS: The reconstruction technique used was the esophagus-jejunal anastomosis end-to-side Roux-en-Y in 257 patients (86.7%). The general complications in the period from 1972 to 1992 totalized 47 cases (43.5%), mainly involving the respiratory (28 cases - 25.9%) and urinary tract (10 cases - 9.2%). In the period from 1993 to 2007 amounted to 48 cases (25%), mainly respiratory complications (27 cases - 14%), followed by urinary (12 cases - 6.2%). The local complications from 1972 to 1992 totalized 45 cases (30.8%) and in the period from 1993 to 2007 amounted to 28 cases (14.5%), being the most frequent the digestive fistulas. The operative mortality through 30 days was 18 cases (6%), while in the period from 1972 to 92 a total of 12 cases (11.1%) and in the period from 1993 to 2007 were 7 cases (3.6%). CONCLUSIONS: Total gastrectomy is a procedure that requires a skilled surgeon, his team, using an improved surgical technique to minimize postoperative complications. The postoperative complications requiring care in controlling infections, airway and nutritional care, reducing mortality, increasing survival and contributing to quality of life of patients.

INTRODUÇÃO: O vírus Epstein-Barr (EBV) está associado a cerca de 10% dos adenocarcinomas gástricos, representando mais de 50 mil casos por ano no mundo. Apesar dos estudos realizados em várias partes do mundo, alguns aspectos clinicopatológicos permanecem controversos. OBJETIVOS: O presente estudo teve como objetivo analisar as características clinicopatológicas de casos de adenocarcinomas gástricos procedentes dos estados de São Paulo e Ceará, correlacionando-os com a detecção de EBV. MATERIAIS E MÉTODOS: Foram obtidos 192 casos de adenocarcinomas gástricos de hospitais dos estados de São Paulo e do Ceará, dos quais 160 foram submetidos à técnica de RNA-hibridização in situ para detecção de EBV. RESULTADOS: Dos 160 casos, 11 (6,9%) foram EBV-positivo, exibindo intensa marcação nuclear em células tumorais. Destes, dois casos também apresentaram linfócitos infiltrados marcados. Não encontramos marcação em tecido normal ou pré-neoplásico. São Paulo e Ceará apresentaram as frequências 3/60 (5%) e 8/100 (8%), respectivamente, e maior relação do EBV com indivíduos do sexo masculino, de idade avançada, com tumores do tipo intestinal, de estadiamento elevado e grau pouco a moderadamente diferenciado. Os casos do Ceará exibiram aumento relativo de tumores EBV(+) localizados na cárdia, enquanto os casos de São Paulo demonstraram aumento naqueles localizados no corpo gástrico. CONCLUSÃO: A frequência de tumores EBV(+) do presente estudo situa-se nos valores descritos na literatura mundial. Entre os achados, um deles não encontra paralelo na literatura mundial e refere-se ao elevado percentual de tumores EBV(+) no corpo gástrico observado nos casos de São Paulo.INTRODUCTION: The Epstein-Barr virus (EBV) has been associated with approximately 10% of gastric adenocarcinomas, which represents more than 50,000 cases/year worldwide. Despite the studies undertaken in several countries, some clinical-pathological aspects remain contentious. OBJECTIVE: The objective of this study was to analyze clinical-pathological features of gastric adenocarcinomas from two Brazilian states, São Paulo and Ceará, by correlating them with EBV detection. MATERIALS AND METHODS: One hundred ninety-two gastric adenocarcinoma cases were selected from hospitals in São Paulo and Ceará, of which 160 were submitted to RNA in situ hybridization for EBV detection. RESULTS: Eleven (6.9%) out of 160 cases were EBV-positive with intense nuclear staining in tumor cells. Among these, two cases also showed stained infiltrating lymphocytes. There was no staining in normal or preneoplastic tissue. São Paulo and Ceará yielded the respective results: 3/60 (5%) and 8/100 (8%). In both states, EBV was more prevalent among elder male patients with little to moderately differentiated intestinal tumors in advanced stage. Ceará cases substantiated a relative increase in EBV(+) tumors located in the cardia, whereas São Paulo cases presented an increase in the gastric corpus. CONCLUSION: The frequency of EBV(+) tumors is similarly described in the literature. Among our findings, the elevated percentage of EBV(+) tumors in the gastric corpus, which was observed in São Paulo cases, is unprecedented in the literature.

Introduction and Aims: Epstein-Barr virus (EBV) infection is an etiologic factor in EBV-associated gastric carcinoma (EBVaGC). The aim of our study was to describe the clinical and histopathologic characteristics of EBV infection in intestinal-type gastric adenocarcinoma samples., Material and Methods: Of 180 paraffin-embedded gastrectomy samples, 28 were studied. Chromogenic in situ hybridization was performed to detect EBV. Sociodemographic and histopathologic data were obtained from the patients' clinical histories., Results: A total of 21.4% of the samples were positive for EBV. The predominant morphologic characteristic was the lace pattern, with dense inflammatory infiltration. Fifty percent of the EBVaGC + patients were men, and the median age of the positive patients was 59 years (range: 50-75); 77.2% of the EBVaGC - patients were men, and the median age of the negative patients was 66 years (range: 34-89). Helicobacter pylori infection was associated with 10.7% of the EBVaGC + patients and 53.6% of the EBVaGC - patients. In the EBVaGC + patients, the cardia was the most frequent tumor location (17.9%), 7.1% had histologic grades 2 and 3, and 17.9% presented with Borrmann classification type III. In the EBVaGC - patients, the cardia and fundus were the most frequent tumor locations (71.4%), 35.7% had histologic grade 2, and 39.3% and 21.4% presented with Borrmann classification type III and IV, respectively., Conclusions: The present study describes the clinical and histopathologic characteristics associated with EBVaGC positivity. Those data may aid in the selection of cases that are candidates for analysis through molecular methods aimed at identifying EBV infection in intestinal-type gastric adenocarcinoma., (Copyright © 2022 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.)

RACIONAL: No câncer gástrico, a incidência, o diagnóstico e as opções terapêuticas apresentaram melhorias nas últimas décadas, porém o prognóstico permanece reservado, especialmente devido à maioria dos pacientes procurarem recurso médico com tumores avançados, metastáticos ou cirurgicamente irressecáveis já no diagnóstico. Biologia molecular é área de conhecimento recente com grandes questionamentos a serem respondidos e a atualidade dos fatos científicos mostra que o caminho deverá ser através da identificação de marcadores tumorais. Os grandes avanços na área da informática aprimoraram a análise da imagem celular através da citofotometria de imagem que possibilita através da imunoistoquímica estudar a proliferação celular e a angiogênese que participa em diversos processos tumorais, sendo pesquisadas por vários marcadores. Atualmente estudos são realizados para demonstrar o valor prognóstico de suas expressões, contudo, no adenocarcinoma gástrico resultados têm sido divergentes e estudos escassos. OBJETIVOS: Identificar e quantificar citofotometricamente a expressão dos marcadores da angiogênese através do fator VIII no adenocarcinoma e comparar suas expressões com fa classificação de Bormann, profundidade de invasão tumoral, grau de diferenciação, envolvimento nodal, padrão histológico e idade. MÉTODOS: Foram estudados 21 pacientes com adenocarcinoma gástrico, identificados de 1998 a 2006. Para a detecção do Fator VIII foi realizada imunoistoquímica, com anticorpo policlonal para Fator VIII. Foi realizada análise citofotométrica informatizada pelo sistema SAMBA 4000. RESULTADOS: Dos 21 pacientes 61,90% eram do sexo masculino e 38,10% do feminino, com idade mediana de 65 anos e apenas um não marcou para o Fator VIII (95,24% de marcação). As médias dos índices de marcagem para o Fator VIII foram de 61,14% (desvio-padrão de 15,06, variando de 29,16 a 73,91). Tumores com classificação III ou IV apresentaram índice de marcagem maiores do que aqueles com Bormann I ou II, porém sem correlação com a profundidade de invasão tumoral, grau de diferenciação, envolvimento nodal e padrão histológico. CONCLUSÕES: O presente estudo identificou e marcou 95,24% das amostras para o Fator VIII. Em relação aos fatores prognósticos não houve correlação significativa exceto entre o Fator VIII e a classificação de Bormann no qual o tipo III ou IV foi maior que o tipo I ou II.INTRODUCTION: Regarding gastric cancer, the incidence, diagnosis and therapeutic options showed improvement in the last decades, but prognosis remains gloomy, specially due the fact that most patients, already diagnosed present advanced tumors, metastatic and not liable to be surgically resected. Molecular biology is an area in science, which can give the answer to many questions and current scientific facts show that the this should be through detection of tumoral markers. The great advances in informatics refined cell image analysis by image cytophotometry makes it possible to study cell proliferation and angiogenesis in various tumor processes using immunohistochemistry and several markers. At present, studies are conducted to demonstrate the prognostic value of their expressions, however, in gastric adenocarcinoma the results have been divergent and studies are scarce. AIM: To identify and quantify the expression of cell proliferation markers using Ki-67 and of angiogenesis with Factor VIII in gastric adenocarcinoma using cytophotometry, and compare their expressions with factors such as Bormanns´ classification, tumor invasion depth, degree of differentiation, nodal involvement, histologic pattern and age. METHODS: Twenty-one patients with gastric adenocarcinoma identified between 1998 and 2006 were studied. Ki-67 and Factor VIII expressions were performed using immunohistochemistry with clone MIB-1 primary antibodies, monoclonal for Ki-67 and policlonal for Factor VIII. Cytophotometric analysis was performed using the SAMBA 4000 system. RESULTS: Of the 21 patients 61.90% were males and 38.10% females, with a median age of 65 years. In our study eight patients had no Ki-67 marking (61,90% marking) and only one had no Factor VIII marking (95,24% marking). Means of Ki-67 labelling index was 33,25% (standard deviation 20,08, varying from 5,43 to 75,10) and of Factor VIII, 61,14% (standard deviation 15,06, varying from 29,16 to 73.91). There was no correlation between the two markers regarding gender and age. When compared between the two markers, expression for angiogenesis was significantly greater than that for cell proliferation with a mean difference between labelling index of 20,89 (p

Objetivo: según la clasificación de Lauren el adenocarcinoma tipo difuso es conocido por tener un comportamiento más agresivo e infiltrante que el adenocarcinoma tipo intestinal. Desde hace una década, diferentes estudios han postulado que esta cualidad del adenocarcinoma tipo difuso se debe en parte a la pérdida de expresión de la molécula E-cadherina, proteína de la membrana celular cuya función es permitir la adhesión intercelular. Métodos: el presente trabajo es un estudio transversal comparativo que mide la expresión de la proteína de adhesión intercelular E-cadherina con la ayuda de inmunohistoquímica, seleccionando aleatoriamente 10 casos de carcinoma de células en anillo de sello y 10 casos de carcinoma tipo intestinal, comparándolos. Resultados: encontramos una mayor expresión de E-cadherina en los adenocarcinomas de tipo intestinal (100%) que en los carcinomas de células en anillo de sello (40%) siendo esta diferencia estadísticamente significativa usando el test de Fisher (p = 0,011). La mayor pérdida de E-cadherina permitiría entender la mayor capacidad infiltrante del adenocarcinoma tipo difuso respecto al adenocarcinoma tipo intestinal.Objective: signet ring carcinoma of the stomach is well known to be more aggressive and infiltrating than adenocarcinoma, different studies have proposed that signet ring cell carcinoma would be more infiltrating because of the lost of E-cadherin expression, this cadherin is a class of protein cell membrane protein which plays an important role in cell-adhesion. Methods: we carried out a transversal comparative study, in order to measure the E-cadherin expression in 10 cases of signet ring cell and in 10 cases of adenocarcinoma, with help of immunohistochemistry. Results: we found a bigger expression of E-cadherin in adenocarcinomas (100%) than signet ring cell carcinoma (40%), this difference was significative using Fisher test (p = 0,011). The lost of E-cadherine would explain the bigger infiltrating capacity in comparison to adenocarcinoma.

A descriptive and retrospective study of 989 patients with endoscopic diagnosis of chronic gastritis whose biopsies had been processed in the Pathology Department of Palma Soriano in Santiago de Cuba, was carried out during 2008-2014, aimed at determining the incidence of the infection due to Helicobacter pylori, for which the variables: age, sex, gastritis types, presence of the organism and its association with malignancies were also considered. In the series the 40-49 years age group (26,7 %) and female sex (69,0 %) prevailed; also, the superficial gastritis was more frequent (57,8 %) and the bacteria was found in 70,5 % of the sample, where only 0,5 was associated to malignancies. [ABSTRACT FROM AUTHOR]

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OBJETIVO: Realizar dosagens da benzilamino-oxidase (BzAO), uma enzima tissular localizada na túnica média dos vasos sanguíneos, mais precisamente no músculo liso, em fragmentos tumorais e não tumorais de peças cirúrgicas ressecadas de portadores de adenocarcinoma gástrico avançado. MÉTODOS: Foram incluídos no estudo 24 doentes (18 masculinos e seis femininos com média de idade de 55,4 anos). Quanto à localização do tumor, eram 11 do antro gástrico, nove do corpo, dois da cárdia, um do corpo e antro e um do fundo, sendo que 12 doentes foram submetidos a gastrectomia subtotal e os demais a gastrectomia total com esplenectomia, todos com linfadenectomia a D2. As dosagens de BzAO foram correlacionadas com idade , sexo , tempo de história da doença, local do tumor no estômago, tipo histopatólogico e cirurgia realizada. RESULTADOS: A atividade enzimática da BzAO nos tecidos gástricos normais variou de 22,9 miM a 111 miM (média de 57,1), sendo superior nos tecidos tumorais em todos os casos, variando de 35,5 miM a 148 miM (média de 70,7). A análise estatística pelo teste t de student mostrou diferença significativa entre as duas dosagens (desvio padrão de 2,373 e p = 0,0263, portanto p < 0,05). CONCLUSÃO: As dosagens de BzAO foram mais elevadas nos fragmentos tumorais gástricos, sugerindo existir correlação entre a BzAO e a angiogênese, e, portanto, a possibilidade de utilização de terapias antiangiogênicas que atuem inibindo o crescimento tumoral e metastático.

Os autores apresentam um caso de encefalopatia de Wernicke em um paciente com síndrome de obstrução pilórica por adenocarcinoma gástrico, sem história de alcoolismo e desnutrição. Comentam aspectos fisiológicos da importância da tiamina como co-enzima da transcetolase e da piruvato-descarboxilase na rota metabólica para produção de ATP e a possibilidade da existência de interação de fatores genéticos e ambientais no surgimento do quadro clínico. Chamam a atenção para a importância do diagnóstico clínico, que deve ser precoce para que a terapêutica específica com tiamina possa surtir efeito, principalmente em pacientes sem história prévia de alcoolismo e desnutrição.The authors present one case of Wernicke's encephalopathy in a patient with obstructive pyloric syndrome caused by gastric adenocarcinoma, wihout previous history of alcoholism or malnutrition. They comment on the importance of physiological aspects of thiamine as a co-enzyme of transketolase and pyruvate-decarboxilase in the metabolic pathway for ATP production and the possibility of existing an interaction between genetical and environmental factors in the onset the symptoms. They draw attention for the clinical diagnosis, which should be precocious for the therapy with thiamine to be efective, especially in patients without previous history of alcoholism or malnutrition.

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Gastric cancer ranks fourth in incidence and second in mortality among all cancers worldwide. Despite the decrease in incidence in some regions of the world, gastric cancer continues to present a major clinical challenge due to most cases being diagnosed in advanced stages with poor prognosis and limited treatment options. The development of gastric cancer is a complex and multifactorial process involving a number of etiological factors and multiple genetic and epigenetic alterations. Among the predisposing factors are: Helicobacter pylori infection, high salt intake, smoking, and in a small percentage of patients, a familial genetic component. More than 95% of stomach cancer cases are adenocarcinomas, which are classified into two major histologic types: intestinal and diffuse. Intestinal type adenocarcinoma is preceded by a sequence of gastric lesions known as Correa´s cascade and is the histologic type associated with the global decrease in gastric cancer rates. Diffuse type adenocarcinomas have a more aggressive behavior and worse prognosis than those of the intestinal type. According to the anatomical location, adenocarcinomas are classified as proximal (originating in the cardia) and distal (originating in the body and antrum). This classification seems to recognize two different clinical entities. Surgical resection of the tumor at an early stage is the only effective treatment method. Therefore, the identification and surveillance of patients at risk may play a significant role in survival rates. Anti-Helicobacter pylori therapy has been shown to be an effective measure in the prevention of gastric cancer. [ABSTRACT FROM AUTHOR]

This is the case of an adult labrador retriever dog with nonspecific signs that compromised its gastrointestinal system. After performing complementary tests, grave alterations of the liver were found. A treatment was begun, but given the systemic compromise of the patient and its poor prognosis, euthanasia was the chosen alternative. In the necropsy, a mass in the lesser curve of the stomach was found, and it compromised the whole wall of this organ. Besides, macroscopic changes in the liver, the omentum, the lymph nodes, the lungs and the diaphragm were observed. In the histopathology test results a diagnosis of gastric adenocarcinoma with liver and lung metastases was achieved. [ABSTRACT FROM AUTHOR]

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Gastric cancer is the most common malignancy of the digestive tract worldwide. Adenocarcinoma accounts for 90%-95% of all malignancies of the stomach. There have been studies on the expression of Her-2/neu in cancer of the stomach. Several studies showed that overall survival and time of occurrence of relapses in patients with these neoplasms was lower in those who had higher levels of this oncogene, suggesting that Her-2/neu could be used as a prognostic factor. Increased expression of Her-2/neu and its accessibility make this receptor a suitable target for direct anti-tumor therapy. Objectives: To assess the expression of Her2/neu in gastric adenocarcinomas. Material and methods: observational, analytical and retrospective study in which we observe the expression of Her-2/neu, were studied in 65 total gastrectomy with a diagnosis of adenocarcinoma, were selected paraffin blocks, to which they were performed with hematoxylin staining and eosin and immunohistochemistry. Results: The immunohistochemical reaction produced by the Her2/neu antibody was positive in only six cases (9.23%), and negative in 59 cases (90.76%). Four (66.66%) were found in body and antrum. It was observed that the expression of Her2/neu is related to the degree of infiltration in four cases (66.66%) was observed in the serous infiltration, and in the remaining two (33.33%) a muscle. Conclusion: We found a low prevalence (9.23%) of the expression of Her2/neu, the figures are within international standards. [ABSTRACT FROM AUTHOR]

We present the case of an adult woman with cardiac tamponade and death associated to pericardial metastasis from a diffuse gastric adenocarcinoma that lacked gastrointestinal clinical manifestations. These diagnoses were not established until post-mortem pathological examination. The clinical differential diagnoses with an autoimmune disease as well as pitfalls in the cytological diagnosis dealing with pericardial effusion material are discussed. Cardiac tamponade due to pericardial metastases from gastrointestinal cancers are exceptional events hardly ever diagnosed in clinical practice. [ABSTRACT FROM AUTHOR]

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Introducción: en 1992 se creó el "Protocolo de Betania", para el diagnóstico y tratamiento del cáncer gástrico en Colombia. A partir de ese momento, en el Hospital Universitario San Ignacio, el manejo de esta patología se ha realizado siguiendo los parámetros de dicho protocolo. El siguiente estudio presenta los resultados de una cohorte prospectiva que incluyó todos los pacientes operados por cáncer gástrico entre 1992 " 1998 en esta institución.

Es un síndrome paraneoplásico poco común, que se asocia a tumores gastrointestinales, más frecuentemente a adenocarcinoma gástrico (69%). Afecta a ambos sexos y no tiene prevalencia por grupo étnico alguno. Clínicamente son lesiones hiperpigmentadas, hipertróficas y verrucosas en zonas de flexión y en la mayoría de los casos, las mucosas también resultan afectadas con lesiones papilomatosas. Habitualmente desaparecen con la eliminación del tumor o reaparecen con la recurrencia o metástasis.Acanthosis nigricans malignant is an uncommon paraneoplastic syndrome associated with gastrointestinal tumors, frequently gastric adenocarcinoma, affects both sexes and it has not prevalence by race. Clinically, lesions are hyperpigmented, hypertrophic and verrucous in flexion areas and in most cases the mucous membranes are also affected with papillomatous lesions. Tipically disappears with the removal of the tumor and reappears when recurrence or metastasis occur.

Se realizó un estudio descriptivo-prospectivo en adultos de ambos sexos, con sospecha clínica y endoscópica de neoplasia maligna gástrica, para describir el comportamiento de la infección por Helicobacter pylori en pacientes con diagnóstico histológico de adenocarcinoma gástrico. Se encontró una frecuencia de adenocarcinoma gástrico de 91 %, localizado principalmente en la región antral 60 %; se constató, mediante prueba de ureasa, que el Helicobacter pylori coloniza con baja frecuencia las zonas alejadas del tumor. Se analizó la histología de la periferia del tumor y se comprobó que 70 % de los adenocarcinomas presentaban Helicobacter pylori en esta zona, al comparar esta frecuencia con la de la región peritumoral (75 %) no existieron diferencias estadísticamente significativas. Se relacionó la presencia de Helicobacter pylori con el tipo de gastritis presente en la mucosa peritumoral, según la localización del tumor, no se observaron diferencias estadísticamente significativas entre la presencia o no de Helicobacter pylori en las distintas regiones donde se estudió la gastritis. En el tipo histológico intestinal se observó un discreto aumento de pacientes con Helicobacter pylori positivo (80 %), no obstante, no existe una relación estadísticamente significativa entre la presencia de Helicobacter pylori y el tipo histológico del tumor. En todas las muestras de biopsia estudiadas, la densidad de Helicobacter pylori fue ligera. Se concluyó que la mayor frecuencia de neoplasia maligna gástrica fue el adenocarcinoma, y no existieron diferencias importantes en la distribución del Helicobacter pylori según el tipo histológico del tumor ni en la gastritis de la mucosa peritumoralA descriptive prospective study was conducted in adults of both sexes with clinical and endoscopic suspicion of malignant gastric neoplasia aimed at describing the behavior of infection caused by Helicobacter pylori in patients with histological diagnosis of gastric adenocarcinoma. It was found a frequency of gastric adenocarcinoma of 91 %. 60 % were mainly located in the antral region. It was confirmed by urease test that Helicobacter pylori colonizes with low frequency the zones distant from the tumor. The histology of the tumor periphery was analized and it was proved that 70 % of the adenocarcinomas presented Helicobacter pylori in this zone. On comparing this frequecny with that of the peritumoral region (75 %), no statistically significant differences were observed. The presence of Helicobacter pylori was related to the type of gastritis present in the peritumoral mucosa, according to the localization of the tumor. No statistically significant differences were detected between the presence or not of Helicobacter pylori in the different regions where gastritis was studied. In the intestinal histological type it was found a discreet increase of patients with positive Helicobacter pylori (80 %). However, there is no a statistically significant relation between the presence of Helicobacter pylori and and the histological type of tumor. In all the studied biopsy specimens the Helicobacter pylori density was mild. It was concluded that the highest frequency of malignant gastric neoplasia was the adenocarcinoma. There were no significant differences neither in the distribution of Hel icobacter pylori according to the histological type of tumor, nor in the gastritis of the peritumoral mucosa