Abstract
Background In China, the incidence of cancer has significantly decreased over the last two decades. In contrast, the incidence of gastric carcinoma (GC) has risen in young patients. Methods We reevaluated the histopathological results of 4,353 endoscopic gastroscopies from the Department of Pathology at No 1 Hospital of Liangshan. The ethnic groups Han and Yi were almost equally distributed in this cohort. Over a five-year period, 1407 GC were diagnosed. Results In 171 of these cases (12%), the patients were ≤40 years old (early-onset GC, EOGC). Out of this cohort, 9 patients were aged ≤25 years. 54% of these patients were male and showed marked predominance (92%) of the Yi-minority. Using the classification of Lauren, 103 GC (60%) were of diffuse type, 27 (16%) of intestinal type, and 41 (24%) of mixed type. In the remaining 1,236 cases of patients ≥41 years (88%), 1,014 patients (82%) belonged to the Yi-minority. Helicobacter pylori (HP) were found in 46% of all cases. Familial clustering was found in 14 patients (18%; in first degree relatives, 12%, and in second degree relatives, 6%). Follow-up was not possible. Conclusion This study demonstrates the unequal manifestation of EOGC within the two ethnic groups of Han and Yi. However, familial clustering was infrequent. Further investigations are necessary to discover relevant risk factors apart from hereditary predisposition.
Highlights
Gastric carcinoma (GC) is the fourth most common type of cancer with a high rate of cancer-related deaths despite manifold therapeutical efforts [1]
An increasing number of cases can be found in young patients under 40 years [2, 3], which is classified as early-onset gastric carcinoma (GC) (EOGC)
Results e distribution of ethnic groups Han and Yi, the ages of patients, and the histological results of endoscopy from 4353 cases are shown in Figure 1. 2143 (49.2%) biopsy specimens were from the Han-majority and 2210 specimens (50.8%) from the Yi-minority, so that a sampling bias could be excluded
Summary
Gastric carcinoma (GC) is the fourth most common type of cancer with a high rate of cancer-related deaths despite manifold therapeutical efforts [1]. Ese include numerous exogenous and environmental factors such as bacterial e Scientific World Journal infections with Helicobacter pylori (HP), variations of lifestyle, and diet [8,9,10,11,12,13,14] as well as genetic or epigenetic abnormalities which affect tumor suppressor genes and mismatch repair genes [15]. In this way, clinical research is faced with a seemingly unsolvable puzzle. Further investigations are necessary to discover relevant risk factors apart from hereditary predisposition
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