MEDIX, God. 15 Br. 82  •  Pregledni članak  •  Gastroenterologija / Onkologija HR ENG

Tumori želucaStomach tumours

Miroslava Katičić

Približno 95% svih malignih tumora želuca otpada na adenokarcinom. Tijekom najvećeg dijela 20. stoljeća, među malignim je tumorima u svijetu želučani adenokarcinom bio vodeći uzrok smrti. Etiologija želučanoga karcinoma je multifaktorijalna. Poznata je sekvenca razvoja za endemski oblik, primarno intestinalni tip želučanoga karcinoma; progresija iz normalne sluznice, preko kroničnoga gastritisa i intestinalne metaplazije, do displazije i neoplazije. Ovaj je razvoj povezan s različitim čimbenicima rizika; Helicobacter pylori-infekcija i visoki unos soli udruženi su s razvojem kroničnog atrofičnoga gastritisa, a visoki unos nitrata vodi do razvoja intestinalne metaplazije. Zbog izrazito nespecifičnih simptoma koji karakteriziraju želučani karcinom, u većine se bolesnika karcinom dijagnosticira u uznapredovaloj fazi. Izbor terapije, ali i ishoda bolesti, ovisi o određivanju proširenosti tumorske bolesti. Zbog činjenice da je petogodišnje preživljavanje bolesnika s uznapredovalom bolesti vrlo nisko, u tijeku je istraživanje i definiranje vrijednosti adjuvantne (poslijeoperativne) i neoadjuvantne (prijeoperativne) radijacijske terapije i/ili kemoterapije u poboljšanju ishoda liječenja

Ključne riječi:
adenokarcinom; atrofični gastritis; Helicobacter pylori; tumori želuca; tumori želuca, diagnoza; tumori želuca, prognoza; tumori želuca, terapija

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 15 Br. 82

Approximately 95% of all malignant gastric neoplasms are adenocarcinomas. Adenocarcinoma of the stomach was the leading cause of cancer-related death worldwide through most of the 20th century. The aetiology of gastric cancer is likely multifactorial. Endemic forms of gastric cancer, primarily of the intestinal type, are known to progress from normal tissue to chronic atrophic gastritis, to intestinal metaplasia, to dysplasia and neoplasia. This progression seems to be associated with different risk factors; Helicobacter pylori infection and high salt intake are associated with chronic atrophic gastritis, whereas high nitrate intake leads to intestinal metaplasia. Due to non-specific symptoms of gastric cancer, most patients are diagnosed with advanced-stage disease. The choice of therapy and outcome of patients with documented gastric cancer depend on the stage of the disease. As the five-year survival rate of patients with advanced disease and extensive lymph node involvement is rather low, adjuvant (postoperative) and neoadjuvant (preoperative) radiation therapy (RT) and/or chemotherapy are being extensively investigated for their potential to improve the treatment outcome of these patient.

Key words:
adenocarcinoma; gastritis, atrophic; Helicobacter pylori; stomach neoplasms; stomack neoplasms, diagnosis; stomach neoplasms, prognosis; stomach neoplasms, therapy