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🌱 來自: gastric cancer

etiologies of gastric cancer

Risk factors

• H. pylori (cagA-positive), tobacco, EtOH (noncardia), obesity/high BMI, GERD, EBV, radiation, pernicious anemia, occupation exposure to coal/rubber
• Nutritional factors: ↑ salt/nitrate diet (synergistic w/ H. pylori), ↑ smoked or cured foods, poor-quality drinking water, diet low in vitamin A/C
• Precursor lesions: Adenomatous gastric polyps, dysplasia, chronic atrophic gastritis, & intestinal metaplasia

Genetics

• Familial cases account for up to 5-10% of all gastric CA
• Lynch: Germline muts of MMR genes (MSH2, MLH1, MLH6, PMS2, EPCAM)
• Diffuse hereditary gastric CA: Germline E-cadherin (CDH1) mut, AD, 60-80% penetrance, consider ppx gastrectomy (NEJM 2001;344:1904)
• Others: FAP, Li-Fraumeni, juvenile polyposis, Peutz-Jeghers