Common gastric and colon (GC) carcinoma with an anomaly in the GC amylase (AMY) gene and good prognosis: clinical findings of common GC carcinoma

Abstract

The common causes and clinical features of gastric and colon (GC) carcinomas were investigated in 218 Japanese patients who underwent gastrectomy and 138 Japanese patients who underwent colectomy over a period of 2.9 years. One characteristic feature of common GC carcinoma was high levels of saliva-type serum amylase (S-Amy). High serum amylase of >400 IU/l, which was secreted from GC carcinoma, was identified in 9% to 12% of the patients immediately after surgery. Besides the high S-Amy, liver (bile duct) and/or kidney cysts and diabetes mellitus (DM) or borderline DM were found in 61–70% and 36–37%, respectively, of these GC carcinoma patients. The liver (bile duct) or kidney cysts may have been induced by a gene anomaly related to GC carcinoma. DM with low levels of insulin could also be connected to GC carcinoma. The pancreatic carcinoma markers, carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA), increased when GC carcinoma had metastasized to the lungs and/or liver. Seven (3%) patients with gastric carcinoma had liver metastasis, but none had lung metastasis. Colon carcinomas, which had better pathological findings than gastric carcinomas, metastasized more frequently with higher CEA levels. Both lung and liver metastases were found in four (3%) patients, lung metastasis in three (2%) patients, and only liver metastasis in five (4%) patients. Early stage metastases via lymph-vascular or large vascular vessels, but not small vein vessels, with a good prognosis of 3–4% mortality rates, were also characteristic findings of GC carcinomas. Some nodules of the metastases fell into necrosis in the metastatic organs. It was concluded that, among the GC carcinoma patients admitted to our hospital, at least 70% of GC carcinomas may be common GC carcinomas, which must have abnormal GC salivary AMY gene promoters.