Diet and Gastrointestinal Cancer

Clinicopathological Study of Lesions of Upper Gastrointestinal Tract

Conditions affecting the upper digestive system are often seen in clinical practice and are associated with a high rate of death and disability. Histopathological confirmation is one of the foundations for good treatment planning and the definite diagnosis of illnesses of the upper gastrointestinal tract. The numerous methods employed in the diagnosis of gastrointestinal lesions have come a long way in the previous 25 years. The identification and diagnosis of gastrointestinal lesions have been substantially aided by the development of endoscopy, endoscopic biopsy, and other surgical techniques. This research aimed to examine the variety of gastrointestinal tract (GI) lesions and to draw connections between the clinical and pathological manifestations of these conditions.

Materials and Methods

A two-year cross-sectional study was conducted in the Department of Pathology, from June 2018 to May 2020, which included surgical specimens of 140 cases from the upper gastrointestinal tract, of which 111 cases were biopsy, and 29 cases were resected surgical specimens. The data were analyzed using SPSS software. Furthermore, P values, sensitivity, specificity, positive predictive value, and negative predictive value were calculated.

Results

This study was a two-year cross-sectional study conducted in the Department of Pathology during the period of June 2018-May 2020.

The effect of antioxidants on MNNG-induced stomach carcinogenesis in rats

The effect of vitamins A, C and E, butylated hydroxytoluene (BHT) and glutathione (GSH) on gastric carcinogenesis induced by N-methyl-N-nitro-N-nitrosoguanidine (MNNG) was investigated. Male and female BD-VI rats 2-3 months old received a single oral application of MNNG dissolved in corn oil. The male rats were divided into four groups: Group-I: MNNG 250 mg/kg by intubation; Group-II: MNNG + vitamin C daily in the drinking water (400 mg/l); Group-III: MNNG + vitamin C (400 mg/l) + 100 g of milk broth (for each of 10 rats) containing vitamin A (40,000 IU), vitamin E (0.5 g) and BHT (0.1 g) three times a week. The treatment with antioxidants started 7 days before the MNNG administration and continued until the end of experiment. Group-IV rats received MNNG + oxyferriscorbone, i.p. as a single dose of 1.0 mg/kg, daily during the week before and the week after MNNG exposure and than 3 times a week till the end of the experiment. Female rats were divided into two groups: Group-I: MNNG 333 mg/kg by intubation; Group-II: MNNG + GSH orally at a dose of 100 mg/rat 1 h before and 5, 24, 48, and 72 h after MNNG intubation. The incidence of gastric tumors after 15 months of treatment was as follows: male rats, 82.4% in Group-I, 40.0% in Group-II, 40.7% in Group-III, and 50.0% in Group-IV; female rats; 72.7% in Group-I, and 36.0% in Group-II.

Gastric carcinoma in the West Indies: a Trinidad study

Gastric carcinoma, the commonest cause of death from malignant disease in Trinidad, has decreased steadily over the period 1968-1977. Of the 1052 deaths during this time, females accounted for a relatively high percentage (45%) of cases. There is a predominance of antral tumors, and most cases present with very advanced disease (88% with Stage III & IV). This results in a low resectability rate (32%). Its racial predilection for blacks of the lower income group suggests that both genetic and environmental factors may be important. The possible role of dietary factors is discussed.

Biochemical mechanisms on species differences in gastric carcinogenesis

The biochemical denitrosation of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) in tissues from four strains of rat, inbred Buffalo, Lewis, B-N, and the random-bred Sprague-Dawley, with different sensitivities to MNNG-induced gastric carcinomas was investigated as a possible explanation for the species/strain differences in MNNG-induced carcinogenesis. An analytical HPLC method was developed to assay denitrosation of MNNG to N-methyl-N'-nitroguanidine (MNG) by cytosolic, microsomal, mitochondrial, and nuclear cell fractions. All the activity was contained in the microsomal and cytosolic fractions, with the major portion occurring in the cytosol. The activity in both fractions was NADPH-dependent, but denitrosation was not reduced by inhibitors of the cytochrome P-450 system. Denitrosation of MNNG post-mitochondrial supernatant (S9) fractions from liver, glandular stomach mucosa, and duodenal mucosa of the four rat strains was determined. In all strains, denitrosation activities were highest in liver. Comparisons between the three strains most sensitive to MNNG-induced gastric carcinogenesis indicated no large differences for any tissue. However, Buffalo, the most resistant strain, did have a higher level of denitrosating activity in all three tissues, which is consistent with the hypothesis that higher levels of detoxifying enzymes may lead to a decreased incidence of tumors. On the other hand, denitrosation accounts for less than 3% of the MNNG that disappears during the incubation period so that the relevance of denitrosation as a mechanism in strain-specific sensitivity to MNNG-induced gastric carcinoma requires additional studies.

Decreased prevalence of gallstones in gastric cancer

The prevalence of gallstones and the frequency of previously performed cholecystectomy were examined in 498 autopsy subjects who had gastric cancer and their age- and sex-matched control subjects. The frequency of gallstones not treated by operation and previous cholecystectomy was significantly (p less than 0.01) lower in those with gastric cancer than in the matched-control subjects. It is not possible to determine on the basis of this study what the possible factors that cause this phenomenon are.

Simultaneous cancer of the pancreas occurring in husband and wife

The simultaneous occurrence of cancer of the pancreas in husband and wife is reported. Both patients shared two dietary idiosyncrasies--namely, (1) the ingestion of copious amounts of margarine in which they cooked all their food and (2) the addition of 'coffee syrup', a liquid concentrate of coffee, to their ground coffee before percolation. The possible role of the latter in the aetiology of pancreatic cancer is discussed.

Preoperative basal chemotherapy in the management of cancer of the stomach: a preliminary report

Nine patients with advanced gastric carcinoma have been treated with a programme of chemotherapy as the first stage of management with the objective of reducing tumour extent and viability in preparation for subsequent surgery where feasible. In eight patients the chemotherapy was given by intraarterial infusion into the coeliac axis, and the remaining patient was given intravenous chemotherapy. Most patients gained symptomatic improvement, including pain relief, and in seven patients tumour regression was achieved. In six patients tumour regression was followed by gastrectomy. Residual tumour was found in five of these six patients, and was not found in one.

Oesophageal cancer in Greenland: selected epidemiological and clinical aspects

During 1955--1974, forty cases of oesophageal cancer were diagnosed among indigenous Greenlanders. The annual incidence rates per 100,000, age adjusted to the "world" population, were 16.3 for males and 11.8 for females in 1955--1964. The corresponding rates in 1965--1974 were 15.9 for males and 6.7 for females with a male:feamle ratio of 2.4:1. These rates rank among the moderately high rates found in India, Puerto Rico and France and in the black population in the US. Age distribution, anatomical location and prognosis followed the normal pattern for oesophageal cancer disease. No particular occupational trend was apparent and there was no difference between towns and settlements. However, a statistically significant geographical gradient of frequency was found with higher rates in the southernmost 3 districts. The traditional Greenland diet may contain concentrations of precursors sufficient to create carcinogenic levels of nitrosamines. Further studies are needed in particular of environmental factors such as foodstuffs, homebrewed beer, drinking water and cigarette smoking. Attention should be focused on the special ecological conditions in southern Greenland.

Nutrients, vitamins and minerals in cancer prevention: facts and fallacies

In this paper, a summary is first presented of the important facts that have linked diet and dietary habits to human cancers, with the purpose of identifying the sources and extent of food fallacies that associate "nutrients, vitamins, and minerals" in cancer prevention. Then examples are presented of the many fallacies that persuade consumers to make dangerous, inappropriate and/or ineffective dietary choices. Minimizing food faddism and dietary quackery with its false claims about diet and cancer requires an important counterchallenge on the part of health professionals. There is a great need to determine the possible role of nutrients and dietary components in the development of neoplastic disease in human populations in order to develop rational and safe food and nutrition policies. Concurrently, nutrition education should receive increased research support in order to improve techniques and approaches for informing policy makers, the food industry and public accurately and objectively of the recent advances in the study of nutrition and cancer prevention and their practical and health significance.

Gastric and colorectal cancer in Greenland. Diagnostic basis and minimum incidence

Forty-three gastric cancers, 38 colon cancers, and 26 cancers of the rectum were diagnosed among indigenous Greenlanders in the 20-year period 1955--1974. When cases based on clinical evidence only were excluded, a comparison with Danes showed significant deficits for male gastric cancers for 1960--1964 and female rectal cancers for 1970--1974. For the 20 years as a whole, gastric cancers in females were significantly lower than expected. Eleven clinical gastric cancers, 5 clinical colon cancers, and an additional 34 malignancies suspected of being primary gastrointestinal cancers had not been exhaustively investigated, mainly owing to metastatic spread and old age at the time of diagnosis. It seems reasonable to assume that the incidences of gastric cancer and of colorectal cancer in Greenland did not differ greatly from the incidences in Denmark during the study period in spite of dietary differences. A more regular use of rather simple examinations in the diagnostic routine is necessary for future epidemiological studies.