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Flashcards in pathology of tumours of the upper GIT Deck (20):
1

what happens to the epithelium of the oesophagus in Barrett's oesophagus?

repeated gastro-eosophageal reflux irritates the squamous epithelium of the oesophagus and causes transformation to columnar epithelium of the intestine

2

what term is used to describe the change in epithelium seen in Barrett's?

METAPLASIA!

3

What is metaplasia?

change in differentiation of a cell from one fully differentiated cell type to a different fully differentiated cell type

4

what type of cancer does Barrett's oesophagus predispose to?

adenocarcinoma

5

what has the trend been in the UK oesophageal cancer incidence?

increase, highest rates in males

6

describe the changes from a normal oesophageal squamous epithelium to neoplastic oesophageal glandular epithelium

reflux affects normal squamous epithelium
this causes metaplastic glandular epithelium
continuing reflux plus other factors causes dysplastic glandular epithelium
continuing reflux and other factors causes neoplastic glandular epithelium
aka normal - metaplastic - dysplastic - neoplastic

7

what are the risk factors for adenocarcinoma of the oesophagus?

obesity
severe reflux

8

what are the risk factors for squamous cell carcinoma of the oesophagus?

smoking
heavy alcohol intake
these risk factors together are synergistic

9

what structures are close to the oesophagus that could be affected by carcinoma?

SVC
aorta
lymph vessels
trachea

10

do people with oesophageal cancer tend to present late or early and how does this affect 5 year survival?

late
the older sb presents with oesophageal cancer, the poorer their 5 yr survival

11

what has the trend been in the UK concerning gastric cancer?

incidence has decreased (could be that some cancers that were once classed as gastric cancers are now glassed as oesophageal and could also contribute to the rise o=in oesophageal cancers)

12

where in the world is gastric cancer most common?

eastern asia
eastern europe

13

what type of foods predispose to gastric cancer?

smoked
pickled
processed

14

what age to people usually get gastric cancer?

disease of older age
after the age of 40

15

what other factors apart from food could lead to gastric cancer?

Helicobacter pylori
pernicious anaemia
genetic changes

16

what are the stages of changes from normal gastric mucosa to invasive carcinoma?

normal gastric mucosa - intestinal metaplasia - dysplasia - intramucosal carcinoma - invasive carcinoma

17

what is linitus plastica?

diffuse spread of cancer cells in the stomach making the wall of the stomach very thick and fibrosed

18

what is in situ cancer of the stomach?

cancer that is contained within the gastric mucosa

19

what is early gastric cancer?

cancer of the stomach that has not spread to the muscular wall (muscularis propria)
it can spread to the lymph nodes, but just not to the muscular wall to be called early

20

what is late gastric cancer?

cancer that has spread to the muscular wall ie muscularis propria