vitamin-b-12 and Stomach-Neoplasms

Inconsistent findings have emerged from epidemiological research investigating the association between vitamin B

Topics: Humans; Prospective Studies; Risk; Stomach Neoplasms; United States; Vitamin B 12; Vitamin B 6; Vitamins

Pernicious anemia is still a neglected disorder in many medical contexts and is underdiagnosed in many patients. Pernicious anemia is linked to but different from autoimmune gastritis. Pernicious anemia occurs in a later stage of autoimmune atrophic gastritis when gastric intrinsic factor deficiency and consequent vitamin B

Topics: Anemia, Pernicious; Gastritis; Humans; Micronutrients; Precancerous Conditions; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Epidemiological studies focusing on the association between vitamin B

Topics: Epidemiologic Studies; Helicobacter Infections; Humans; Stomach Neoplasms; Vitamin B 12; Vitamins

Atrophic gastritis (AG) results most often from Helicobacter pylori (H. pylori) infection. AG is the most important single risk condition for gastric cancer that often leads to an acid-free or hypochlorhydric stomach. In the present paper, we suggest a rationale for noninvasive screening of AG with stomach-specific biomarkers.. The paper summarizes a set of data on application of the biomarkers and describes how the test results could be interpreted in practice.. In AG of the gastric corpus and fundus, the plasma levels of pepsinogen I and/or the pepsinogen I/pepsinogen II ratio are always low. The fasting level of gastrin-17 is high in AG limited to the corpus and fundus, but low or non-elevated if the AG occurs in both antrum and corpus. A low fasting level of G-17 is a sign of antral AG or indicates high intragastric acidity. Differentiation between antral AG and high intragastric acidity can be done by assaying the plasma G-17 before and after protein stimulation, or before and after administration of the proton pump inhibitors (PPI). Amidated G-17 will rise if the antral mucosa is normal in structure. H. pylori antibodies are a reliable indicator of helicobacter infection, even in patients with AG and hypochlorhydria.. Stomach-specific biomarkers provide information about the stomach health and about the function of stomach mucosa and are a noninvasive tool for diagnosis and screening of AG and acid-free stomach.

Topics: Achlorhydria; Antibodies, Bacterial; Biomarkers; Gastric Mucosa; Gastrins; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Mass Screening; Pepsinogen A; Pepsinogen C; Stomach Neoplasms; Vitamin B 12

Pernicious anemia is a macrocytic anemia due to cobalamin deficiency, which is the result of intrinsic factor deficiency. Pernicious anemia is associated with atrophic body gastritis, whose diagnostic criteria are based on the histologic evidence of gastric body atrophy associated with hypochlorhydria. Serological markers suggesting the presence of oxyntic mucosa damage are increased levels of fasting gastrin and decreased levels of Pepsinogen I. Without the now obsolete Schilling's test, intrinsic factor deficiency may not be proven, and gastric intrinsic factor output after pentagastric stimulation has been proposed. Intrinsic factor autoantibodies are useful surrogate markers of pernicious anemia. The management of patients with pernicious anemia should focus on the life-long replacement treatment with cobalamin and the monitoring to early diagnose an eventual onset of iron deficiency. Moreover, these patients should be advised about possible gastrointestinal long-term consequences, such as gastric cancer and carcinoids.

Topics: Achlorhydria; Anemia, Pernicious; Carcinoid Tumor; Humans; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

A 69-year-old woman reported marked restriction of voluntary movements of the hands in the preceding 6 months. She had also experienced loss of motivation, memory and concentration. Her skin was pale yellow, and scratches on her skin indicated marked pruritus.. Neurological examination revealed decreased vibratory sense in both legs. Haemoglobin concentration was 8.3 g/dl, mean corpuscular volume 114 fl, vitamin B12 level < 100 ng/l, folic acid level normal. Antibody titre against parietal cells was increased, vitamin B12 resorption diminished. Gastroscopy revealed small raised lesions, made up of hyperplastic cells which stained with chromogranin, indicating a diagnosis of microcarcinoid of the gastric mucosa.. On administration of cobalamine (1,000 micrograms i.m. daily for 2 weeks, twice weekly for 6 weeks, then once per week for the last 7 months) the blood picture returned to normal, but the microcarcinoids, the psychological symptoms and the apraxia of the hands were unchanged.

Topics: Aged; Carcinoid Tumor; Chronic Disease; Female; Gastritis, Atrophic; Hematinics; Humans; Memory Disorders; Nervous System Diseases; Psychopathology; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adrenal Cortex Hormones; Anemia, Pernicious; Animals; Antibodies; Autoantibodies; Biopsy; Chronic Disease; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Intrinsic Factor; Schilling Test; Stomach; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Anemia, Hypochromic; Anemia, Pernicious; Animals; Burns, Chemical; Celiac Disease; Diagnosis, Differential; Gastric Juice; Gastritis; Humans; In Vitro Techniques; Intrinsic Factor; Peptic Ulcer; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aflatoxins; Airway Resistance; Animals; Anthracenes; Benzopyrenes; Cricetinae; Female; Heterocyclic Compounds; Humans; Hydrocarbons; Lactones; Lung Neoplasms; Male; Mice; Mouth Neoplasms; Naphthalenes; Nicotiana; Phenols; Plants, Toxic; Rats; Skin Neoplasms; Smoking; Stomach Neoplasms; Urinary Bladder Neoplasms; Vitamin B 12

Topics: Antibodies; Autoradiography; Chronic Disease; Depression, Chemical; Duodenal Ulcer; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Insulin; Intrinsic Factor; Methods; Protein Binding; Radioisotopes; Stimulation, Chemical; Stomach Neoplasms; Vitamin B 12

Patients undergoing proximal gastrectomy (PG) with double-tract reconstruction (DTR) have been reported to have an incidence of reflux esophagitis that is as low as that observed after total gastrectomy (TG). It is unclear whether PG has an advantage over TG for the treatment of patients with upper early gastric cancer (GC).. To evaluate the effect of laparoscopic PG with DTR (LPG-DTR) vs laparoscopic TG (LTG) on levels of hemoglobin and vitamin B12 supplementation required among patients with clinically early GC in the upper third of the stomach (upper-third early GC).. This multicenter open-label superiority randomized clinical trial was conducted at 10 institutions in Korea. A total of 138 patients with upper-third cT1N0M0 GC were enrolled between October 27, 2016, and September 9, 2018. Follow-up ended on December 3, 2020.. Patients were randomized to undergo either LPG-DTR or LTG.. The primary co-end points were change in hemoglobin level and cumulative amount of vitamin B12 supplementation at 2 years after LPG-DTR or LTG. The secondary end points included morbidity, postoperative reflux esophagitis, quality of life, overall survival, and disease-free survival. Quality of life outcomes were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) 30-item core questionnaire (C30) and the EORTC QLQ stomach cancer-specific questionnaire at 3 months, 12 months, and 24 months.. Among 138 patients (mean [SD] age, 60.0 [10.9] years; 87 men [63.0%]; all of Asian race and Korean ethnicity), 68 (mean [SD] age, 56.7 [10.4] years; 39 men [57.4%]) were randomized to receive LPG-DTR and 69 (mean [SD] age, 61.3 [11.3] years; 48 men [69.6%]) were randomized to receive LTG. The mean (SD) changes in hemoglobin levels from baseline to month 24 were -5.6% (7.4%) in the LPG-DTR group and -6.9% (8.3%) in the LTG group, for an estimated difference of -1.3% (95% CI, -4.0% to 1.4%; P = .35). The mean (SD) cumulative amount of vitamin B12 supplementation was 0.4 (1.3) mg in the LPG-DTR group and 2.5 (3.0) mg in the LTG group, for an estimated difference of 2.1 mg (95% CI, 1.3-2.9 mg; P < .001). The late complication rates in the LPG-DTR and LTG groups were 17.6% and 10.1%, respectively (P = .31). The incidence of reflux esophagitis was not different between the LPG-DTR and LTG groups (2.9% vs 2.9%; P = .99). Compared with the LTG group, the LPG-DTR group had better physical functioning scores (85.2 [15.6] vs 79.9 [19.3]; P = .03) and social functioning scores (89.5 [17.9] vs 82.4 [19.4]; P = .03) on the EORTC QLQ-C30. Two-year overall survival (98.5% vs 100%; P = .33) and disease-free survival (98.5% vs 97.1%; P = .54) did not significantly differ between the LPG-DTR vs LTG groups.. In this study, patients with upper-third early GC who received LPG-DTR required less vitamin B12 supplementation than those who received LTG, with no increase in complication rates and no difference in overall and disease-free survival rates. There was no difference in change in hemoglobin level between groups. In addition, the LPG-DTR group had better physical and social functioning than the LTG group. These findings suggest that LPG-DTR may be as safe as LTG and may be a function-preserving procedure for the treatment of patients with upper-third early GC.. ClinicalTrials.gov Identifier: NCT02892643.

Topics: Dietary Supplements; Female; Gastrectomy; Hemoglobins; Humans; Laparoscopy; Male; Middle Aged; Quality of Life; Stomach Neoplasms; Treatment Outcome; Vitamin B 12

This prospective multi-central randomized phase II trial evaluated the efficacy and safety of oral Vitamin B12 500 μg/day replacement compared with oral Vitamin B12 1,500 μg/day in patients with Vitamin B12 deficiency after total gastrectomy for gastric cancer.. Patients were randomly assigned to receive oral Vitamin B12 500 μg/day or Vitamin B12 1,500 μg/day in a 1:1 ratio with a minimization method. The primary endpoint was the incidence of a normal serum Vitamin B12 level at three months after treatment.. From January 2018 to December 2021, 3 institutions collaborated with the present study, and 74 patients were registered from these 3 institutions. The study was prematurely closed due to poor accrual after reaching almost 50% of its goal. Among the 74 recruited patients, 36 were allocated to the Vitamin B12 500 μg/day arm and 38 to Vitamin B12 1,500 μg/day arm. The incidences of patients with a normal Vitamin B12 level at 3 months (serum Vitamin B12 level >200 pg/ml) were 91.7% (33/36) in the Vitamin B12 500 μg/day arm and 100% (38/38) in the Vitamin B12 1,500 μg/day arm (p=0.3587). The types of clinical symptoms with Vitamin B12 deficiency that improved with Vitamin B12 treatment and the degree of improvement were also similar.. Although the primary endpoint of the present study was not met, it was found that oral Vitamin B12 500 μg/day replacement is as effective and safe as oral Vitamin B12 1,500 μg/day replacement for Vitamin B12 deficiency.

Topics: Gastrectomy; Humans; Prospective Studies; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Previous studies have found associations between one-carbon metabolism nutrients and risk of several cancers, but little is known regarding upper gastrointestinal tract (UGI) cancer. We analyzed prediagnostic serum concentrations of several one-carbon metabolism nutrients (vitamin B12, folate, vitamin B6, riboflavin and homocysteine) in a nested case-control study within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study of male smokers, which was undertaken in Finland between 1985 and 1988. We conducted a nested case-control study including 127 noncardia gastric adenocarcinoma (NCGA), 41 esophagogastric junctional adenocarcinoma and 60 esophageal squamous cell carcinoma incident cases identified within ATBC. Controls were matched to cases on age, date of serum collection and follow-up time. One-carbon nutrient concentrations were measured in fasting serum samples collected at baseline (up to 17 years prior to cancer diagnosis). Odds ratios and 95% confidence intervals (CI) were calculated using conditional logistic regression. Lower prediagnostic vitamin B12 concentrations at baseline were associated with a 5.8-fold increased risk of NCGA (95% CI = 2.7-12.6 for lowest compared to highest quartile, p-trend <0.001). This association remained in participants who developed cancer more than 10 years after blood collection, and after restricting the analysis to participants with clinically normal serum vitamin B12 (>300 pmol/L). In contrast, pepsinogen I, a known serologic marker of gastric atrophy, was not associated with NCGA in this population. As vitamin B12 absorption requires intact gastric mucosa to produce acid and intrinsic factor, our findings suggest vitamin B12 as a possible serologic marker for the atrophic gastritis that precedes NCGA, one more strongly associated with subsequent NCGA than pepsinogen.

Topics: Aged; alpha-Tocopherol; beta Carotene; Carcinoma, Squamous Cell; Case-Control Studies; Dietary Supplements; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Finland; Folic Acid; Homocysteine; Humans; Male; Middle Aged; Prospective Studies; Riboflavin; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Patients treated in a randomized controlled comparison of management of benign gastric ulcer of the body of the stomach, comprising 50 patients treated by Billroth I partial gastrectomy and 50 patients treated by vagotomy and pyloroplasty and biopsy of the ulcer, were followed up for about five years (range one and a half to eight and a half years). No statistically significant difference has been found between the functional results (Visick grading) of the two groups. There was no operative mortality. Postoperative morbidity (17 against 5) and length of stay in hospital (14 against 10 days) were significantly greater after gastrectomy. Seven patients after vagotomy have been submitted to gastrectomy (three for recurrent gastric ulceration, three for gastric cancer, and one for bleeding), which is a statistically significant excess compared with no reoperation after gastrectomy. While vagotomy and pyloroplasty can be useful to avoid a technically difficult gastrectomy, it cannot be said to replace partial gastrectomy in the treatment of gastric ulcer.

Topics: Clinical Trials as Topic; Folic Acid; Follow-Up Studies; Gastrectomy; Gastrointestinal Hemorrhage; Hemoglobinometry; Humans; Iron; Length of Stay; Postoperative Complications; Pylorus; Recurrence; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer; Vagotomy; Vitamin B 12

A high cobalamin level has been related to non-malignant diseases (mainly liver diseases, alcoholism, and renal diseases) and cancer (hematological malignancies and solid cancers such as liver and stomach cancer). However, a previous high level of cobalamin and the implications in the possible development of cancer is still unclear. The main aim of this study was to describe if a previous high cobalamin level is a determinant in the future development of cancer in five years of follow-up. The secondary objective was to determine any differences between cancer groups.. A retrospective study was performed. Two databases were employed. The first one included all patients who had a determination of cobalamin in a routine blood test during the year 2010 (a total of 44,166 patients). The second one showed every patient who was admitted to the reference hospital, Hospital Clinico Universitario de Valladolid, during the following five years. Finally, a number of 6710 patients was included. Both databases belong to the medical records of the Hospital Data Surveillance System and are completely validated. Multivariate logistic regression analyses were employed to evaluate the association between cobalamin levels and the appearance of cancer (total and in each subgroup). All analyses were performed using IBM SPSS 24 software (IBM Corp., Armonk, NY, USA).. The sample studied showed a clear association between the risk of hematological cancer and a previous high Cbl level. This relationship was higher among patients with the highest levels (over 779 pmol/L), showing almost two times more risk for development of hematological malignance within 5 years in the multivariate analysis (OR: 1.975, 95% CI: 1.056-3.697, P=0.033). Hematological malignancies were mostly diagnosed within the first three years (86.6%), showing a similar percentage in those three years. There was no association between this previous level and the development of any other type of cancer.. Our study shows that a high cobalamin plasma level (hypervitaminosis) is associated with the development of hematologic cancer within five years after the measurement. The clinical implication of these findings, together with the clinical suspicion, reinforces the necessity of carrying out specific screening hematological tests in patients with not justified elevated plasma cobalamin levels. New prospective and multicenter studies are necessary to validate these results.

Topics: Hematologic Neoplasms; Humans; Prospective Studies; Retrospective Studies; Stomach Neoplasms; Vitamin B 12

Patients are at-risk for vitamin B12 deficiency after total gastrectomy due to a lack of intrinsic factors. The aim of the study was to clarify the clinical course and risk factors for vitamin B12 deficiency after total gastrectomy for gastric cancer patients.. Patients who underwent curative resection for gastric cancer were selected from the medical records of the Yokohama City University from 2000 to 2020. A logistic regression analysis was performed to identify risk factors for vitamin B12 deficiency.. We evaluated 47 patients. The median serum vitamin B12 levels before surgery were 359 pg/ml, while those at 3, 6, 9, and 12 months after surgery these were 255 pg/ml, 197.5 pg/ml, 195 pg/ml, and 206 pg/ml, respectively. Univariate analyses to identify factors associated with vitamin B12 deficiency at 6 months after surgery showed that the occurrence of postoperative complications was a significant risk factor (OR=6.347, 95%CI=1.607-25.774, p=0.009), while adjuvant chemotherapy was a marginally significantly risk factor (OR=3.562, 95%CI=0.877-14.477, p=0.076).. Almost half of the patients were diagnosed with vitamin B12 deficiency at 6 months after total gastrectomy for gastric cancer. In addition, the occurrence of postoperative complications and adjuvant chemotherapy were risk factors for vitamin B12 deficiency at 6 months after surgery.

Topics: Disease Progression; Gastrectomy; Humans; Postoperative Complications; Risk Factors; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Gastrectomy causes vitamin B-12 deficiency since vitamin B-12 requires gastric acid and intrinsic factor for its absorption. Vitamin B-12 deficiency is considered to develop years after gastrectomy because of large hepatic storage. However, most gastric cancer develops after long-standing atrophic gastritis with vitamin B-12 malabsorption.. We have investigated vita-min B-12 status in 22 patients before gastrectomy and 53 patients after gastrectomy due to gastric cancer, also with consideration on post-gastrectomy anemia.. Blood vitamin B-12, folic acid, homocysteine concentrations, parameters of anemia, and dietary intake were evaluated. Percentage of patients with severe vitamin B-12 deficiency (serum vitamin B-12 < 150 pmol/L), vitamin B-12 deficiency (150 pmol/L to < 258 pmol/L) was 19.0 %, and 52.4 % respectively in patients gastrectomized within three years. Before gastrectomy, three and seven patients exhibited severe deficiency and deficiency, respectively. In gastrectomized patients, plasma homocysteine concentration was inversely associated with serum vitamin B-12 concentration, and vitamin B-12 deficiency- and iron deficiency- anemia coexisted with their mean corpuscular volume within the reference range.. Vitamin B-12 deficiency is prevalent in patients early after and before gastrectomy. Coexistence of vitamin B-12 and iron deficiency obscures the diagnosis of post-gastrectomy anemia, and necessitates the blood vitamin B-12 measurement.

Topics: Anemia, Iron-Deficiency; Gastrectomy; Homocysteine; Humans; Iron Deficiencies; Prevalence; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Stomach cancer is the fourth most common type of cancer worldwide. TCN1 mainly encodes the vitamin B12 transporter, transcobalamin. TCN1 is a marker of gastrointestinal tumor progression, but the impact of TCN1 on survival is unclear.. Gastrointestinal tumor records were reviewed and analyzed, clinicopathological data were summarized, immunohistochemical detection of TCN1 was performed again, and the protein expression in tumor tissue, non-tumor tissue, and lymph nodes was semi-quantitatively analyzed. Patients were followed up for 5 years to determine the 5-year survival rates.. The strong immune reactivity of the TCN1 protein was significantly correlated with tumor invasion depth, regional lymph nodes, and a tumor diameter of >5 cm (Z = -2.531 and P = .016; Z = 3.785 and P < .001; Z = 2.541 and P = .049). Kaplan-Meier survival analysis showed that the total survival time of patients in the low-expression TCN1 group was significantly longer than that in the high-expression TCN1 group (P = .001; Table 2 and Figure 5). The mean survival time of all patients was 49.774 months (95% CI: 47.871-51.676; Table 4) and the 5-year overall survival rates were 73.3, 50.8, and 34.0%, respectively. Multivariate analysis revealed that regional lymph nodes (HR = 1.253; 95% CI: 1.031-1.747, P = .012), TCN1 immune expression status (HR = 2.707; 95% CI: 1.068-1.886, P = .016), and pTNM staging (HR = 2.293; 95% CI: 1.583-3.321; P = .001) were independent risk factors for poor survival.. The high expression of TCN1 in gastric tumor tissues was found to be associated with the clinicopathological factors of patients, and the high expression of TCN1 was shown to indicate a poor clinical prognosis.

Topics: Gastrectomy; Humans; Neoplasm Staging; Prognosis; Retrospective Studies; Stomach Neoplasms; Survival Rate; Transcobalamins; Vitamin B 12

Topics: Albumins; Anastomosis, Roux-en-Y; Cholesterol; Gastrectomy; Hemoglobins; Humans; Laparoscopy; Postoperative Complications; Retrospective Studies; Stomach Neoplasms; Treatment Outcome; Vitamin B 12

Previous evidence has suggested roles for α-synuclein propagation and vitamin B12 (VitB12) deficiency in the pathogenesis of Parkinson's disease (PD). We investigated whether gastric cancer (GC) patients who underwent gastrectomy had a lower risk of PD and whether VitB12 supplementation modified the risk.. GC patients aged ≥50 years who underwent curative gastrectomy between 2007 and 2012 (n = 72,216) and matched comparison groups (n = 211,389) were identified from the Korean National Health Insurance database. The risks of PD were analyzed by Cox regression.. Compared to their matched comparison groups, GC patients who underwent gastrectomy showed a decreased risk of PD (adjusted HR [aHR] 0.86; 95% confidence interval [CI] 0.75-0.98), but the significance disappeared after further adjustment with smoking and body mass index (BMI). To elaborate, subtotal gastrectomy (STG) was associated with decreased risk of PD (aHR 0.85; 95% CI 0.74-0.99) while total gastrectomy (TG) was not (aHR 0.89; 95% CI 0.66-1.19), although the risk reduction was not significant when further adjusted for smoking and BMI. Among the patients who underwent TG, their risk of PD was markedly lower when they had VitB12 supplementation after surgery (aHR 0.36; 95% CI 0.17-0.76), while the risk was higher when they did not have any (aHR 1.55; 95% CI 1.03-2.32).. GC patients who underwent gastrectomy and received uninterrupted VitB12 supplementation had a decreased incidence of PD. This study provides indirect epidemiological evidence for the potential roles of gastrectomy and VitB12 in the pathogenesis of PD.

Topics: Aged; Female; Follow-Up Studies; Gastrectomy; Humans; Male; Middle Aged; Parkinson Disease; Republic of Korea; Risk; Stomach Neoplasms; Vitamin B 12

Among various methods, the use of targeting nucleic acid therapy is a promising method for inhibiting gastric cancer (GC) cells' rapid growth and metastasis abilities. In this study, vitamin B12-labeled poly (d,l-lactide-co-glycolide) and polyethylene glycol nanoparticles (PLGA-PEG-VB12 NPs) were developed for microRNAs-532-3p mimics incorporating as targeting gene delivery systems (miR-532-3p@PLGA-PEG-VB12 NPs) to fight against transcobalamin II (CD320)-overexpressed GC cells' progression. The PLGA-PEG-VB12 NPs with appropriate particle sizes and good bio-compatibility could be selectively delivered into CD320-overexpressed GC cells, and significantly decrease the expression of apoptosis repressor with caspase recruitment domain (ARC). Following that, more pro-apoptotic protein (Bax) flowed from cytoplasm into mitochondria to form Bax oligomerization, thus induced mitochondrial damage, including mitochondrial membrane potentials (MMPs) loss and excessive production of mitochondrial reactive oxygen species (mitoROS). Since that, mitochondrial permeability transition pore (mPTP) was opened, followed by induced more cytochrome c (Cyto C) releasing from mitochondria into cytosol, and finally activated caspase-depended cell apoptosis pathway. Therefore, our designed miR-532-3p@PLGA-PEG-VB12 NPs showed enhanced GC targeting ability, and could induce apoptosis through activating ARC/Bax/mitochondria-mediated apoptosis signaling pathway, finally remarkably suppressed proliferation of GC cells both in vitro and in vivo, which presented a promising treatment for GC.

Topics: Antigens, CD; Apoptosis; Caspase Activation and Recruitment Domain; Humans; MicroRNAs; Nanoparticles; Polyethylene Glycols; Receptors, Cell Surface; Stomach Neoplasms; Vitamin B 12; Vitamins

This study aimed to investigate the efficacy of enteral supplementation of vitamin B12 for vitamin B12 deficiency in patients who underwent total gastrectomy for gastric cancer.. The study enrolled 133 patients who underwent total gastrectomy for gastric cancer at Kochi Medical School. Clinical data were obtained to investigate associations between vitamin B12 supplementation and vitamin B12 levels. Vitamin B12 deficiency was defined as serum vitamin B12 less than 200 pg/mL. Baseline characteristics and changes in hematological variables, including vitamin B12 levels, were examined.. Vitamin B12 deficiency was present in 71.4% of the 133 patients. Vitamin B12 levels at 3, 6, and 12 months after enteral supplementation were 306 pg/mL, 294 pg/mL, and 367 pg/mL, respectively, which were all significantly higher than those before supplementation (p < 0.001 for all comparisons). The median red blood cell count at 3, 6, and 12 months after enteral supplementation were 380 × 104/mm3, 394 × 104/mm3, and 395 × 104/mm3, respectively, which were all significantly higher than those before supplementation (p = 0.020, p = 0.001, and p = 0.003, respectively). Vitamin B12 levels at 3, 6, and 12 months after supplementation were significantly higher in patients supplemented enterally than those supplemented parenterally (p < 0.001 for all comparisons).. Vitamin B12 deficiency was found in 71.4% of postoperative patients who underwent total gastrectomy for gastric cancer, and enteral vitamin B12 supplements might be effective to improve anemia in these patients.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Dietary Supplements; Enteral Nutrition; Female; Gastrectomy; Humans; Male; Middle Aged; Postoperative Period; Retrospective Studies; Stomach Neoplasms; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency

As a worldwide infectious bacterium,. This study has been conducted on 289 patients who have met the inclusion criteria. Within these patients, 213 of them were. In conclusion, B12 deficiency was positively correlated with CagA positivity and gastric inflammatory activity.

Topics: Adolescent; Adult; Aged; Antigens, Bacterial; Atrophy; Bacterial Proteins; Female; Gastric Mucosa; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Stomach; Stomach Neoplasms; Virulence Factors; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Our previous research has introduced sericin micelles to reverse drug resistance. However, these micelles could not selectively bind to gastric cancer (GC) cells. We developed vitamin B12 (VB12) conjugated sericin micelles for targeted GC therapy.. We used VB12, sericin, synthetic poly(γ-benzyl-L-glutamate) (PBLG) and paclitaxel (PTX) to develop VB12-conjugated and PTX-loaded micelles (VB12-sericin-PBLG-PTX). Then we explored their physicochemical properties, cellular uptake and antitumor mechanism.. VB12-sericin-PBLG-PTX micelles were proved to be of appropriate particle size, have good dispersion and are bio-safe. Following transcobalamin II (CD320)-receptor-mediated endocytosis, these swallowed micelles with GC-targeting and enhanced cellular uptake abilities, alter mitochondrial transmembrane potential/apoptosis pathway and reverse drug resistance.. VB12-sericin-PBLG-PTX micelles are promising materials for GC-targeted clinical applications.

Topics: Animals; Antigens, CD; Cell Line, Tumor; Drug Carriers; Drug Delivery Systems; Drug Resistance, Neoplasm; Endocytosis; Humans; Micelles; Paclitaxel; Particle Size; Polymers; Receptors, Cell Surface; Sericins; Stomach Neoplasms; Transcobalamins; Vitamin B 12

OBJECTIVE To identify minimally invasive biomarkers to help differentiate dogs with gastric carcinoma from those with chronic gastritis. DESIGN Prospective study. ANIMALS 15 dogs with gastric carcinoma, 29 dogs with chronic gastritis, and 7 healthy dogs. PROCEDURES Dogs with clinical signs of upper gastrointestinal tract disease for > 14 days that underwent gastroscopy or necropsy for collection of gastric biopsy specimens for histologic evaluation were prospectively enrolled. Gastric carcinoma and chronic gastritis were diagnosed on the basis of histologic findings. Additionally, gastric biopsy specimens were collected endoscopically from 7 healthy (control) dogs while they were anesthetized for a routine neutering procedure. Prior to being anesthetized for gastroscopy or euthanized, all dogs underwent a physical examination, and a blood sample was collected for quantification of select serum biomarker concentrations. Histologic findings, body condition score (BCS), and serum biomarker concentrations were compared among the 3 groups. RESULTS Dogs with gastric carcinoma were significantly older and had a significantly lower BCS, lower serum folate concentration, and greater serum C-reactive protein (CRP) concentration, compared with dogs with chronic gastritis and control dogs. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that age > 8 years, BCS < 4, serum CRP concentration > 25 mg/L, and an abnormally low serum folate concentration might be useful noninvasive biomarkers for identification of dogs with gastric carcinoma. For underweight older dogs with signs of upper gastrointestinal tract disease and high serum CRP and low serum folate concentrations, gastric biopsy specimens should be obtained and evaluated so that a prompt definitive diagnosis can be made and appropriate treatment initiated.

Topics: Aging; Animals; Biomarkers; Blood Cell Count; Body Composition; Carcinoma; Cytokines; Dog Diseases; Dogs; Female; Folic Acid; Gastritis; Male; Stomach Neoplasms; Vitamin B 12

Topics: Adult; Aged; Biomarkers; Female; Gastrectomy; Homocysteine; Humans; Male; Methylmalonic Acid; Middle Aged; Postoperative Complications; Retrospective Studies; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Gastric Acid; Humans; Proton Pump Inhibitors; Risk; Stomach Neoplasms; Vitamin B 12

Laparoscopic distal gastrectomy (LDG) is a widely used minimally invasive surgery. Following LDG, Billroth-I (B-I) provides physiological reconstruction by preserving the duodenal passage but results in a high incidence of reflux esophagitis that decreases postoperative quality of life. Because of this, Roux-en-Y (R-Y) reconstruction is often considered the first choice after LDG. However, very few studies have investigated differences in physiological function between B-I and R-Y after LDG. We hypothesized that B-I would outperform R-Y in clinical and physiological outcomes, including nutrition parameters.. We compared hemoglobin, ferritin, serum iron, Vitamin B12, 25(OH)-Vitamin D (V-D), body weight, and gastric emptying after LDG in patients with either B-I or R-Y reconstruction.. The levels of hemoglobin in the B-I group were significantly higher than that in the R-Y group at all time points later than 6 months postsurgery. The ferritin levels were significantly higher in the B-I group at all time points later than 9 months postsurgery. The concentration of serum V-D in the B-I group was significantly higher than that in the R-Y group at 1 year 6 months, 1 year 9 months, and 2 years after surgery. Gastric emptying in the R-Y group was significantly slower than in the B-I group.. Our data indicate that B-I leads to less postsurgical iron deficiency anemia and V-D deficiency compared with R-Y reconstruction. Furthermore, gastric emptying was preserved in B-I reconstruction compared with R-Y reconstruction. In conclusion, after LDG, B-I reconstruction seems to cause fewer nutritional complications than R-Y reconstruction.

Topics: Aged; Anastomosis, Roux-en-Y; Case-Control Studies; Female; Ferritins; Gastrectomy; Gastric Emptying; Gastroenterostomy; Hemoglobins; Humans; Laparoscopy; Male; Middle Aged; Nutritional Status; Reoperation; Retrospective Studies; Stomach Neoplasms; Treatment Outcome; Vitamin B 12; Vitamin D

This study investigated long-term trends in hematological and nutritional parameters after gastrectomy for gastric cancer and evaluated the influence of the reconstruction type on these trends.. The medical records of 558 patients who underwent curative gastrectomy with standard lymph node dissection for stage I gastric cancer between January 2006 and December 2013 were reviewed. The hematological and nutritional parameters evaluated included hemoglobin, ferritin, vitamin B. Although malabsorption and malnutrition are common in patients after a gastrectomy, most nutritional parameters were stable or decreased slightly in the long-term and were not markedly influenced by the reconstruction type or extent of gastrectomy. Therefore, for more accurate nutritional assessment after gastrectomy, multidirectional monitoring should be considered rather than simply measuring biochemical parameters.

Topics: Aged; Anastomosis, Roux-en-Y; Calcium; Cholesterol; Female; Ferritins; Follow-Up Studies; Gastrectomy; Hemoglobins; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Nutritional Status; Postoperative Period; Serum Albumin; Stomach Neoplasms; Time Factors; Triglycerides; Vitamin B 12

Gastric cancer is one of the leading causes of cancer mortality worldwide. Accumulating evidence suggests that vitamin B12 plays an important role in the development of gastric cancer. Genome-wide association studies on metabolites in the one-carbon metabolism pathway identified several vitamin B12-related polymorphisms. Therefore, we investigated the association between variants within vitamin B12-related genes and gastric cancer in a Han Chinese population. Eight variants within the genome were significant vitamin B12-related genes, and they were selected for analysis in this case-control study. This study used a total of 492 gastric cancer patients and 550 noncancer controls. The variant rs526934 from the TCN1 gene was associated with an increased risk of developing gastric cancer. Increased risks of gastric cancer occurrence were observed in the minor G allele (OR = 1.25, 95% CI = 1.03-1.52, P = 0.031) and GG genotype (OR = 2.06, 95% CI = 1.24-3.42, P = 0.0043) compared with the wild-type A allele and AA-GA genotype, respectively. In the haplotypic analysis, we found that the CUBN haplotypes were associated with an altered gastric cancer risk. The rs1801222T/rs11254363A (OR = 1.40, 95% CI = 1.05-1.86, P = 0.021) and rs1801222C/rs11254363G (OR = 4.39, 95% CI = 2.32-8.30, P < 0.0001) haplotypes exhibited an increased gastric cancer risk, while rs1801222T/rs11254363G showed protective effects against gastric cancer (OR = 0.43, 95% CI = 0.25-0.73, P = 0.002) compared with the wild-type rs1801222C/rs11254363A haplotype. The circulating vitamin B12 concentration-related variants were associated with the occurrence of gastric cancer. This finding shed light on the unexpected role of vitamin B12 metabolism genes in gastric carcinogenesis and highlighted the interplay of diet, genetics, and human cancers.

Topics: Adenocarcinoma; Aged; Alleles; Asian People; Case-Control Studies; Female; Fucosyltransferases; Galactoside 2-alpha-L-fucosyltransferase; Gene Expression Regulation, Neoplastic; Gene Frequency; Genome-Wide Association Study; Haplotypes; Humans; Male; Middle Aged; Neoplasm Staging; Polymorphism, Single Nucleotide; Receptors, Cell Surface; Risk Factors; Stomach Neoplasms; Transcobalamins; Vitamin B 12

Double tract anastomosis (DTA) is a recently revisited reconstruction method for preventing reflux esophagitis in laparoscopy-assisted proximal gastrectomy (LAPG). However, only few studies have shown the advantages of LAPG-DTA.. Seventeen patients underwent LAPG-DTA compared to 17 patients undergoing laparoscopy-assisted total gastrectomy (LATG) matched with preoperative stage. Laboratory results, including hemoglobin, serum ferritin, serum iron and vitamin B12, were compared.. Reflux esophagitis developed in two and one patient in the LAPG-DTA and LATG groups, respectively. In the laboratory analysis, fewer patients experienced decrease of serum ferritin below the low normal limit in the LAPG-DTA group. There was a significantly lower proportion of patients in the LAPG-DTA group whose vitamin B12 level decreased below the low normal limit.. LAPG-DTA has the advantages of allowing absorption of iron and vitamin B12 without reflux esophagitis in proximal early gastric cancer compared to LATG.

Topics: Aged; Anastomosis, Surgical; Female; Gastrectomy; Gastroesophageal Reflux; Humans; Iron; Laparoscopy; Male; Middle Aged; Postoperative Complications; Stomach Neoplasms; Vitamin B 12

A 58-year-old woman, who had undergone total gastrectomy for early gastric cancer 9 years previously, visited the outpatient clinic complaining of progressive difficulty in walking for 15 d. Laboratory examinations showed macrocytic anemia and a decreased serum vitamin B12 concentration and increased serum concentrations of folate, vitamin E and copper. Magnetic resonance imaging showed multifocal high signal intensities along the posterior column of the cervical and thoracic spinal cord. Treatment consisted of intramuscular injections of vitamin B12 for 7 d, which increased her serum level of vitamin B12 to normal. This was followed by weekly intramuscular injections of vitamin B12 for another 2 wk and oral administration of vitamin B12 three times per day. After comprehensive rehabilitation for 4 wk, she showed sufficient improvements in strength and ataxic gait, enabling her to return to her normal daily activities.

Topics: Administration, Oral; Ataxia; Diagnosis, Differential; Female; Gait; Gastrectomy; Humans; Magnetic Resonance Imaging; Middle Aged; Stomach Neoplasms; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency; Walking

B vitamins play an essential role in DNA synthesis and methylation, and may protect against oesophageal and gastric cancers. In this case-cohort study, subjects were enrolled from the General Population Nutrition Intervention Trial in Linxian, China. Subjects included 498 oesophageal squamous cell carcinomas (OSCCs), 255 gastric cardia adenocarcinomas (GCAs), and an age- and sex-matched sub-cohort of 947 individuals. Baseline serum riboflavin, pyridoxal phosphate (PLP), folate, vitamin B12, and flavin mononucleotide (FMN) were measured for all subjects. We estimated the associations with Cox proportional hazard models, with adjustment for potential confounders. Compared to those in the lowest quartile of serum riboflavin, those in the highest had a 44% lower risk of OSCC (HR: 0.56, 95% CI: 0.41 to 0.75). Serum vitamin B12 as a continuous variable was observed to be significantly inversely associated with OSCC (HR: 0.95, 95% CI: 0.89 to 1.01, P for score test = 0.041). Higher serum FMN levels were significantly associated with increased risk of OSCC (HR: 1.08, 95% CI: 1.01 to 1.16) and GCA (HR: 1.09, 95% CI: 1.00 to 1.20). Our study prompted that B vitamins have the potential role as chemopreventive agents for upper gastrointestinal cancers.

Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Squamous Cell; Cardia; China; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Female; Flavin Mononucleotide; Folic Acid; Humans; Male; Middle Aged; Niacin; Proportional Hazards Models; Prospective Studies; Pyridoxal Phosphate; Riboflavin; Stomach Neoplasms; Vitamin B 12; Vitamin B Complex

After total (TG) or distal subtotal gastrectomy (DG), patients are at high risk of vitamin B12 (vit-B12) deficiency, which results in elevation of homocysteine levels. The changing of serum vit-B12 and homocysteine levels in patients with gastric cancer is not well known. Seventy-two patients with gastric cancer who had undergone currative gastrectomy and 50 healthy controls were included. Serum vit-B12 and homocysteine levels were analyzed in gastric cancer patients. In addition, these parameters were compared with those of healthy control subjects. While serum vit-B12 levels in gastrectomized patients were significantly lower than that of healthy controls (221.8 ± 125.6 pg/mL vs. 309.9 ± 174.3 pg/mL, p = 0.002), homocysteine levels were significantly higher in patients with gastric cancer (14.2 ± 6.7 μmol/L vs. 12.5 ± 6.1 μmol/L, p = 0.016). Mean serum folate level was found to be high in healthy controls (7.3 ng/mL) compared to patients (9.2 ng/mL, p = 0.027). Out of 72 patients, 40 patients (55.6 %) with gastric cancer developed vit-B12 deficiency after gastrectomy. Vit-B12 deficiency was found to be related with gastrectomy type (p = 0.02) and homocysteine levels (p = 0.014). In patients who underwent TG, the incidence of vit-B12 deficiency was significantly higher compared with those with DG (67.5 vs. 32.5 %). In addition, serum vit-B12 level in patients with DG was significantly higher than that of patients with TG (248.3 ± 122.0 pg/mL vs. 200.8 ± 126.7 pg/mL, p = 0.041), whereas homocysteine levels were significantly lower in DG group compared with TG group (12.1 ± 6.1 μmol/L vs. 15.8 ± 6.9 μmol/L, p = 0.014). A logistic regression analysis showed that the extent of gastrectomy was found to be an independent factor for predicting the occurrence of vit-B12 deficiency (p < 0.001, odds ratio 1.38). Our results showed that cumulative vit-B12 deficiency rate was significantly higher after TG compared with that after DG, while homocysteine levels were significantly higher in TG group compared with DG group. The extent of gastrectomy was found to be an independent factor for predicting the occurrence of vit-B12 deficiency. Vit-B12 deficiency and hyperhomocysteinemia are imperious clinical situation for patients with gastric cancer after surgery. Hence, both preoperative and regular postoperative monitoring of vit-B12 and homocysteine levels for all gastrectomized patients with gastric cancer are important and necessary for early detection and prevention

Topics: Adult; Aged; Aged, 80 and over; Female; Folic Acid; Gastrectomy; Homocysteine; Humans; Hyperhomocysteinemia; Male; Middle Aged; Risk Factors; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Evidence is accumulating regarding a role of micronutrients in folate metabolism in cancer risk. We investigated the associations of plasma folate, vitamin B12, and homocysteine with upper gastrointestinal (GI) cancers in a population-based case-control study in Taixing City, China. With informed consent, we recruited cases with cancers of esophagus (n = 218), stomach (n = 206), and liver (n = 204), and one common healthy control group (n = 405). A standardized epidemiologic questionnaire was used in face-to-face interviews, and blood samples were collected during interviews. We observed an inverse association between plasma folate levels and liver cancer. The adjusted odds ratio (aOR) was 0.46 [95% confidence interval (CI) = 0.24-0.88] comparing individuals in the highest quartile to those in the lowest. We found a positive association between plasma vitamin B12 levels and all three cancers. The aORs for those in the highest quartile were 2.80 (95% CI = 1.51-5.18) for esophageal cancer, 2.17 (1.21-3.89) for stomach cancer, and 9.97 (4.82-20.60) for liver cancer, comparing to those in the lowest quartile. We further observed interaction between plasma folate and vitamin B12 on these cancers. Our data indicated associations between plasma folate and vitamin B12 with upper GI cancers in Chinese population. Further research is warranted considering the debate over the necessity of food fortification.

Topics: Adult; Aged; Case-Control Studies; China; Esophageal Neoplasms; Female; Folic Acid; Homocysteine; Humans; Liver Neoplasms; Male; Middle Aged; Odds Ratio; Risk Factors; Stomach Neoplasms; Surveys and Questionnaires; Vitamin B 12

Nutrients in the one-carbon metabolism pathway may be involved in carcinogenesis. Few cohort studies have investigated the intakes of folate and related nutrients in relation to gastric and esophageal cancer.. We prospectively examined the association between self-reported intakes of folate, methionine, vitamin B6, and vitamin B12 and gastric and esophageal cancer in 492,293 men and women.. We observed an elevated risk of esophageal squamous cell carcinoma with low intake of folate (relative risk (95% confidence interval): Q1 vs Q3, 1.91 (1.17, 3.10)), but no association with high intake. Folate intake was not associated with esophageal adenocarcinoma, gastric cardia adenocarcinoma, or non-cardia gastric adenocarcinoma. The intakes of methionine, vitamin B6, and vitamin B12 were not associated with esophageal and gastric cancer.. Low intake of folate was associated with increased risk of esophageal squamous cell carcinoma.

Topics: Carcinoma, Squamous Cell; Cohort Studies; Diet; Esophageal Neoplasms; Female; Folic Acid; Humans; Male; Methionine; Middle Aged; Risk; Stomach Neoplasms; United States; Vitamin B 12; Vitamin B 6

Topics: Aged; Carcinoid Tumor; Female; Humans; Memory Disorders; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Vitamin B12 deficiency is a common long-term sequelae after total gastrectomy. Intramuscular injection of vitamin B12 is the only known treatment. We investigated the efficacy and safety of oral vitamin B12 replacement for gastric cancer patients with vitamin B12 deficiency after total gastrectomy.. We performed a single-arm, open-label, fixed-drug dosage, prospective study (NCT00699478) involving gastric cancer patients who underwent total gastrectomy. Vitamin B12-deficient (<200 pg/ml) patients (n = 30) received daily oral vitamin B12 (dosage: 1500 μg mecobalamin) administration for 3 months. The primary outcome measurement was serum vitamin B12. The secondary outcome measurements were improvement of neurologic symptoms and hematologic findings (serum folate, homocysteine, ferritin, iron, total iron binding capacity, transferrin, and mean corpuscular volume). For comparison, another group of vitamin B12 deficient patients (n = 30) received intramuscular vitamin B12 injections (dosage: 1000 μg cyanocobalamin) weekly for 5 weeks and monthly thereafter for a total of 3 months in a separate study period.. In both groups, mean serum vitamin B12 increased after 30 days of treatment and was maintained up to 90 days. No adverse effects related to oral or intramuscular vitamin B12 replacements were noted. Both groups showed decreased homocysteine levels. Before treatment, 29 patients in the oral vitamin B12 group had neurologic symptoms related to vitamin B12 deficiency. After oral vitamin B12 treatment, 28 patients experienced symptom relief, and 16 patients were symptom free.. Oral vitamin B12 replacement is an effective and safe treatment for vitamin B12 deficiency in gastric cancer patients after total gastrectomy.

Topics: Administration, Oral; Biological Availability; Female; Follow-Up Studies; Gastrectomy; Humans; Male; Middle Aged; Postoperative Complications; Prognosis; Prospective Studies; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Female; Gastrectomy; Humans; Male; Postoperative Complications; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

To assess gastric cancer survival in relation to dietary intake of methyl donors and the methylenetetrahydrofolate reductase 677C>T (MTHFR 677C>T) polymorphism.. A prospective cohort of 257 incidental, histologically confirmed gastric cancer cases was assembled in January 2004 and followed until June 2006. Patients were recruited from the main oncology and/or gastroenterology units in Mexico City and were queried regarding their sociodemographic information, clinical history, and dietary habits 3 y before the onset of their symptoms. The intake of methyl donors was estimated with a food-frequency questionnaire and the MTHFR 677C>T polymorphisms were determined by polymerase chain reaction/restriction fragment length polymorphism analysis. Cox's multivariate regression models were used to estimate the mortality risk of gastric cancer.. MTHFR 677TT carriers with low folate and vitamin B12 intakes had the lowest survival rate in cases of gastric cancer. High intakes of folate and vitamin B12 before diagnosis was associated with decreased gastric cancer mortality risk in susceptible MTHFR 677TT carriers (mortality risk for folate 0.14, 95% confidence interval 0.04-0.46, P for trend=0.001; mortality risk for vitamin B12 0.23, 95% confidence interval 0.08-0.66, P for trend=0.008).. Folate and related B vitamins may be used as an intervention strategy to improve the survival outcome of gastric cancer.

Topics: Adult; Aged; Diet; Diet Surveys; Female; Folic Acid; Genetic Predisposition to Disease; Humans; Male; Methylenetetrahydrofolate Reductase (NADPH2); Mexico; Middle Aged; Polymorphism, Single Nucleotide; Proportional Hazards Models; Prospective Studies; Risk Factors; Stomach Neoplasms; Surveys and Questionnaires; Survival Analysis; Vitamin B 12; Vitamin B Complex; Young Adult

A 73-year-old white man was referred to a cancer genetics clinic for evaluation of a approximately 20-year history of mixed upper and lower gastrointestinal polyposis, including hyperplastic, inflammatory and adenomatous polyps, colonic ganglioneuromas, and associated diffuse, esophageal glycogenic acanthosis. Two synchronous gastric carcinomas had been identified before referral and the patient had undergone a total gastrectomy, omentectomy and cholecystectomy. Multiple hyperplastic polyps and small, sessile polyps were also observed in the gastrectomy specimen.. History and physical examination, upper and lower gastrointestinal endoscopy and biopsy, genetic testing, molecular pathology investigations (immunohistochemistry), thyroid ultrasonography, fine-needle aspiration of a thyroid nodule.. Cowden's syndrome.. Genetic counseling, thyroidectomy, vitamin B(12) supplementation, continued endoscopic surveillance and genetic testing of at-risk family members.

Topics: Aged; Biopsy, Needle; Carcinoma; Endoscopy, Gastrointestinal; Gastrointestinal Diseases; Genetic Counseling; Genetic Techniques; Hamartoma Syndrome, Multiple; Humans; Immunohistochemistry; Male; Polyps; Stomach Neoplasms; Thyroid Gland; Thyroidectomy; Ultrasonography; Vitamin B 12

Gastric carcinoid tumors are rare but increasing in incidence. Current recommendations suggest endoscopic resection for type I carcinoids found in the stomach, however reports of incomplete resection have led to difficulty planning future management. Our purpose was to describe the application of the endoscopic multi-band mucosectomy (MBM) device to achieve en-bloc resection of multiple gastric carcinoid tumors.. Over a 30-month period (June 2006-January 2009) eight patients attending for endoscopic assessment of gastric carcinoid tumors were identified at two tertiary referral centers. Patients underwent endoscopic resection of the carcinoids with an MBM device. En-bloc specimens underwent histological evaluation for identification and tumor resection margins. Patients with type I carcinoids were subsequently enrolled in an endoscopic follow-up program.. A total of 34 gastric carcinoid tumors were removed from eight patients. On histological analyses seven out of eight patients were diagnosed with type I tumors. In the remaining patient a single, sporadic (type III) gastric carcinoid was diagnosed. No complications of severe bleeding or perforation occurred. All specimens were shown to have clear deep and peripheral histological resection margins.. Complete 'en-bloc' endoscopic resection of multiple 'type I' gastric carcinoid tumors can be safely and easily performed with an MBM technique.

Topics: Adult; Aged; Australia; Biomarkers; Biopsy; Carcinoid Tumor; Female; Gastric Mucosa; Gastrins; Gastroscopy; Humans; Male; Middle Aged; Neoplasms, Multiple Primary; Stomach Neoplasms; Treatment Outcome; Vitamin B 12

Multiple studies have reported an association between disturbances of folate metabolism and increased risk of gastric cancer, including low intake of folate, low levels of folate in blood or genetic factors affecting folate metabolism. Among the genetic factors, in particular a common polymorphism in the gene encoding for 5,10-methylenetetrahydrofolate reductase (MTHFR C677T) has been linked to gastric cancer. Other polymorphisms in folate-metabolising genes have been less frequently investigated. Therefore, we analyzed this polymorphism, the glutamate carboxypeptidase (GCP) II C1561T and the reduced folate carrier (RFC) G80A in a case-control study involving 106 patients with histologically confirmed and characterized gastric cancer with adjustment for other established risk factors for gastric cancer in comparison to 106 age- and sex-matched controls. Neither the MTHFR nor the GCP gene polymorphisms showed an association to cancer diagnosis, to tumor stage, grade of differentiation or Lauren type. However, non-cardia cancers were more likely to exhibit the 80GA and 80AA RFC genotypes, compared to cancers of the gastric cardia (adjusted OR 0.28; 95% CI=0.11-0.71). Thus, gene polymorphisms of the RFC gene might contribute to an increased risk of developing distal gastric cancer.

Topics: Aged; Carboxypeptidases; Case-Control Studies; Female; Folic Acid; Gene Frequency; Genetic Predisposition to Disease; Genotype; Homocysteine; Humans; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Polymorphism, Genetic; Risk Factors; Stomach Neoplasms; Vitamin B 12

Previous studies have shown inconsistent associations of folate intake and polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene with gastric cancer risk. Our nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort is the first prospective study of blood folate levels and gastric cancer. Gastric cancer cases (n=247) and controls (n=631) were matched for study center, age, sex, and time of blood donation. Two common single nucleotide polymorphisms of the MTHFR gene were determined, as were plasma concentrations of folate, cobalamin (vitamin B12), total homocysteine, and methylmalonic acid (cobalamin deficiency marker) in prediagnostic plasma. Risk measures were calculated with conditional logistic regression. Although no relations were observed between plasma folate or total homocysteine concentrations and gastric cancer, we observed a trend toward lower risk of gastric cancer with increasing cobalamin concentrations (odds ratio, 0.79 per SD increase in cobalamin; P=0.01). Further analyses showed that the inverse association between cobalamin and gastric cancer was confined to cancer cases with low pepsinogen A levels (marker of severe chronic atrophic gastritis) at the time of blood sampling. The 677 C-->T MTHFR polymorphism was not associated with gastric cancer, but we observed an increased risk with the variant genotype of the 1298 A-->C polymorphism (odds ratio, 1.47 for CC versus AA; P=0.04). In conclusion, we found no evidence of a role of folate in gastric cancer etiology. However, we observed increased gastric cancer risk at low cobalamin levels that was most likely due to compromised cobalamin status in atrophic gastritis preceding gastric cancer.

Topics: Adult; Aged; Case-Control Studies; Cohort Studies; Europe; Female; Folic Acid; Gastritis, Atrophic; Homocysteine; Humans; Male; Methylenetetrahydrofolate Reductase (NADPH2); Methylmalonic Acid; Middle Aged; Polymorphism, Single Nucleotide; Prospective Studies; Risk Factors; Stomach Neoplasms; Vitamin B 12

In order to clarify vitamin E malabsorption after gastric surgery, we evaluated serum vitamin E level and neurological consequences in patients who had undergone gastrectomy for gastric cancer.. We studied forty-eight patients (30 men, 18 women) with a mean age of 68.0 years, who had previously undergone gastrectomy for gastric cancer and had no evidence of recurrence. The types of operation consisted of subtotal gastrectomy in 26 patients and total gastrectomy in 22 patients. We measured postoperative body weight, white blood cells, red blood cells, hemoglobin, hematocrit, platelets, and serum levels of vitamins E, vitamin B12, folic acid, total cholesterol, triglycerides, total protein, and albumin.. Serum vitamin E level was decreased in 7 (14.6%) of the 48 patients. The occurrence of low vitamin E level was significantly more frequent in the total gastrectomy group than in the subtotal gastrectomy group. In relation to reconstruction procedures, the incidence of low vitamin E level was significantly higher in patients without food passage through the duodenum. The low vitamin E level was significantly associated with low total cholesterol level. The incidence of neuropathy was significantly higher in patients with low vitamin E level.. We assume that vitamin E deficiency more likely occurs after the reconstruction procedure in which food does not pass through the duodenum. Transport disturbance with loss of passage through the duodenum consequently may be the major cause of malabsorption. Differential diagnosis of neurological symptoms in post-gastrectomy patients should include hypovitaminosis E.

Topics: Aged; Female; Gastrectomy; Humans; Malabsorption Syndromes; Male; Middle Aged; Nervous System Diseases; Postgastrectomy Syndromes; Postoperative Complications; Regression Analysis; Stomach Neoplasms; Treatment Outcome; Vitamin B 12; Vitamin E

To compare tests for intestinal function with clinical scores after abdominal irradiation.. At the Department of Radiotherapy, Erfurt, Germany, intestinal changes were studied in 91 patients receiving abdominal radiotherapy between 1992 and 1996. Conventional fractionation (1.8-2 Gy per fraction, total doses 30.6-62.5 Gy) was applied. Before and at weekly intervals during radiotherapy, the clinical response was scored according to RTOG/EORTC for the upper and lower gastrointestinal (GI) tract. Resorption tests for vitamin B(12) and D-xylose were performed before the onset and immediately after treatment.. The clinical response displayed a well-defined dose-effect relationship with grade 1 effects in 5% and 50% of the patients at about 10 Gy and 50 Gy, respectively. For grade 2 reactions, 5%- and 50%-effective doses were 20-30 Gy and 60-80 Gy. Effects in the upper and lower GI tract were highly correlated. Changes in body weight did not show a correlation with other clinical symptoms. Changes in resorption also displayed a significant dose effect. However, no correlation was found with the clinical symptoms in the individual patient.. In the present study, the clinical manifestation of intestinal side effects according to RTOG/EORTC criteria was reflected by neither the vitamin B(12) nor by the D-xylose resorption test. Hence, these tests cannot be regarded as useful for objective quantitation of intestinal radiation injury.

Topics: Abdomen; Adolescent; Adult; Aged; Dose Fractionation, Radiation; Dose-Response Relationship, Radiation; Female; Hodgkin Disease; Humans; Intestinal Absorption; Intestines; Kidney Neoplasms; Lymphoma, Non-Hodgkin; Male; Middle Aged; Prospective Studies; Radiation Injuries; Radiotherapy; Radiotherapy Dosage; Rhabdomyosarcoma; Seminoma; Stomach Neoplasms; Testicular Neoplasms; Time Factors; Vitamin B 12; Xylose

We report a rare case of subacute combined degeneration of the spinal cord concomitant with gastric cancer. A 67-year-old man was admitted because of posterior column symptoms, pyramidal tract sign and peripheral neuropathy with severe hyperchromic anemia. He was treated with mecobalamin 1 mg IM, after which his anemia and neurological signs recovered. He was diagnosed as having subacute combined degeneration with pernicious anemia. Subsequent stomach biopsy revealed gastric cancer, and the patient underwent gastrectomy. It is a well known association that chronic atrophic gastritis is associated with gastric cancer or subacute combined degeneration. Our findings suggest that in this case subacute combined degeneration and gastric cancer are independent of each other; rather, both resulted from chronic atrophic gastritis.

Topics: Aged; Anemia, Hypochromic; Humans; Male; Nerve Degeneration; Peripheral Nervous System Diseases; Spinal Cord; Spinal Cord Diseases; Stomach Neoplasms; Vitamin B 12

Hyperhomocysteinemia is a risk factor for cardiovascular disease, dementia and depression. Prevalence rate of hyperhomocysteinemia in gastrectomized patients is not well elucidated.. We compared plasma total homocysteine, vitamin B12 and folate of gastrectomized male patients with those of control subjects.. Total homocysteine was higher in gastrectomized patients than in control subjects (11.7 +/- 4.4 micromol/l vs. 9.3 +/- 2.4 micromol/l, P = .011), while vitamin B12 was lower in patients than in control subjects (382 +/- 211 pg/ml vs. 500 +/- 179 pg/ml, P = .020). Folate of the two groups was comparable (5.8 +/- 2.5 ng/ml vs. 5.9 +/- 2.2 ng/ml). Of 31 gastrectomized patients six (19.4%) showed low vitamin B12 (<233 pg/ml), four (12.9%) low folate (<3.0 ng/ml) and seven (22.6%) hyperhomocysteinemia (>14 micromol/l), whereas they were found in one (3.2%), none (0%) and one (3.2%) of 31 control subjects, respectively. Patients who had undergone gastrectomy because of cancer showed higher total homocysteine compared to patients who had undergone it because of peptic ulcer. Type of surgery did not correlate with total homocysteine in the present study.. Hyperhomocysteinemia is not rare in male Japanese gastrectomized patients.

Topics: Case-Control Studies; Folic Acid; Gastrectomy; Homocysteine; Humans; Hyperhomocysteinemia; Japan; Male; Middle Aged; Peptic Ulcer; Risk Factors; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adenocarcinoma; Gastrectomy; Humans; Injections, Intramuscular; Prognosis; Stomach Neoplasms; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Acute Disease; Folic Acid; Gastrectomy; Humans; Male; Middle Aged; Peripheral Nervous System Diseases; Stomach Neoplasms; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B 6 Deficiency; Vitamin B Complex

A 54-year-old man was admitted to hospital with dyspnoea, giddiness, lack of appetite and burning sensation in the tongue for 3 years. Gastritis was known from his history. Clinical examination showed jaundice, glossitis, systolic murmur and pallhypesthesia of both legs.. Blood and bone marrow investigations revealed pernicious anaemia. At gastroscopy, fundal gastritis was diagnosed and two small polyps of the fundus were removed. Histologically, one of the two polyps turned out to be a gastric carcinoid type 1 (according to [16]). Additional investigations (x-ray, ultrasound of the abdomen, somatostatin-receptor scintigraphy) did not find any metastases.. With the diagnosis of a pernicious anaemia the patient was treated with vitamin B12. The original symptoms and the anaemia disappeared. Additional therapy of the gastric carcinoid was not necessary. One year after beginning of the treatment, no signs of the gastric carcinoid were found.. In gastric polyps of patients with pernicious anemia neoplastic transformations will often be found. That is why polypectomy should always be done. The best therapy of the gastric carcinoids type 1, which are the most frequently gastric carcinoids, is endoscopic tumour removal. Surgery is the treatment of choice only for gastric carcinoids type 2 to 4. Concerning quality of life and costs, endoscopic treatment is better for patients with gastric carcinoids type 1 than conventional surgical therapy.

Topics: Anemia, Pernicious; Carcinoid Tumor; Diagnosis, Differential; Follow-Up Studies; Gastritis; Gastroscopy; Humans; Male; Middle Aged; Polyps; Stomach; Stomach Neoplasms; Time Factors; Vitamin B 12

A number of causes of malnutrition after total gastrectomy have been proposed. The purpose of this study was to assess nutritional status and to determine the cause of malnutrition after total gastrectomy. We studied 20 gastric cancer patients who had undergone total gastrectomy and immunochemotherapy and 6 normal controls. Nutritional status was assessed by dietary history, anthropometric methods, and serologic measurements. Malabsorption tests included the fecal fat excretion test, D-xylose absorption test, glucose tolerance test, vitamin B12 absorption test using dual isotopes, bacterial culture of jejunal aspirates, and jejunal biopsy. Weight loss was compared to the preoperative status in all patients (average 15%: 59.0 +/- 9.9 vs. 50.2 +/- 7.8 kg, preoperatively vs. postoperatively). Average daily calorie intake was 1586.2 kcal, which is lower than the normal intake of Korean adults (1838 kcal). Malnutrition of skeletal and visceral protein was not found. There was, however, severe fat malnutrition and a deficit of body fat. Postoperatively the body mass index was considerably lower than that preoperatively (22.2 +/- 0.4 vs. 18.9 +/- 0.4 kg/m2; preoperatively vs. postoperatively). With malabsorption tests, the daily excreted amount of fecal fat was 28.6 +/- 3.4 g (mean +/- SD) in patients and 6.9 +/- 0.2 g in controls. There was no significant malabsorption of carbohydrates. In 64.3% (9/14) of patients, vitamin B12 absorption was abnormal; and the serum concentration of vitamin B12, which was significantly related to malabsorption of this vitamin, was lower than normal in 73.7% (14/19). Bacterial overgrowth was not found, and there were no abnormal histologic findings in the jejunal mucosa. These results suggest that poor oral intake and fat malabsorption following total gastrectomy cause malnutrition and that fat malabsorption may be related to relative pancreatic insufficiency.

Topics: Body Weight; Energy Intake; Female; Gastrectomy; Glucose Tolerance Test; Humans; Jejunum; Male; Middle Aged; Nutrition Disorders; Nutritional Status; Postoperative Complications; Stomach Neoplasms; Vitamin B 12; Xylose

The occurrence of gastric carcinoid tumors during the cure of pernicious anemia has been reported in the literature. Concerning a new case, we review physiopathological data of this infrequent association.. We report the case of a 47-year-old women with pernicious anemia in which gastroscopy found two small tumors developed from enterochromaffin-like cells.. These tumors are usually latent and developed from enterochromaffin-like cells. The pathologic and histologic diagnosis is based on positive chromogranin A immunomarking. The physiopathological mechanism studies are in favour of the predominant part of hypergastrinemia following achlorhydria. Usually, evolution is benign and surgical or endoscopic resection recommended.

Topics: Anemia, Pernicious; Carcinoid Tumor; Chromogranin A; Chromogranins; Enterochromaffin-like Cells; Female; Follow-Up Studies; Gastroscopy; Humans; Immunohistochemistry; Middle Aged; Stomach Neoplasms; Time Factors; Vitamin B 12

The Authors report the case of a 83 year old woman with large cystic polyps of the stomach. Gastric cystic polyps are polypoid lesions which may develop following functional disorders such as increased mucosal stimulation by gastrin, or excessive retention of gastric secretions. The incidence of these polyps is variable, depending on their being underestimated since they are not always macroscopically visible. The case here reported is very interesting not only for the number of lesions (over 50), but also for their size (5-25 mm in diameter).

Topics: Aged; Aged, 80 and over; Anemia, Iron-Deficiency; Female; Folic Acid; Gastrointestinal Agents; Gastroscopy; Hematinics; Humans; Polyps; Stomach Neoplasms; Ursodeoxycholic Acid; Vitamin B 12

One hundred and thirty-seven cases of stomach cancer given fluoropyrimidines (UFT: 66 cases, Tegafur: 58 cases, 5-FU: 13 cases) after gastrectomy as the adjuvant chemotherapy were examined as to appearance of macrocytic anemia. The mean corpuscular volume (MCV) gradually elevated in all cases but seven after administration. Macrocytic anemia, defined by the elevation over 20% compared with both pre-operative and pre-administrative values of MCV, was developed 30.3% in UFT group, 8.6% in tegafur group and 30.8% in 5-FU group. The incidence was statistically higher in UFT group (p less than 0.01) and 5-FU group (p less than 0.05) than in tegafur group. The cause was attributed to fluoropyrimidine administration because the serum folate and vitamin B12 levels remained normal and the value of MCV normalized after cessation of administration. Each total dose to induce macrocytic anemia was potentially about 70g in UFT. 100g in tegafur and 30 g in 5-FU. In conclusion, periodical hematological examination is necessary for the patients given fluoropyrimidine preparations.

Topics: Anemia, Macrocytic; Antineoplastic Combined Chemotherapy Protocols; Erythrocyte Indices; Female; Fluorouracil; Folic Acid; Humans; Male; Retrospective Studies; Stomach Neoplasms; Tegafur; Uracil; Vitamin B 12

In a prospective study vitamin B12 concentration was assayed in 22 patients before and 6.4 years after partial gastrectomy. S-B12 had decreased from 496 to 274 pg/ml, p less than 0.001. Four patients had pathological values and two were already on B12 substitution because of deficiency. No difference in B12 concentration was found between patients with gastric or duodenal ulcers or between Billroth I and II operations. Other hematological tests were normal, and the nutritional status of the patients was satisfactory. It is concluded that regular postoperative controls of S-B12 or prophylactic B12 therapy is indicated in these patients.

Topics: Gastrectomy; Hematologic Tests; Humans; Peptic Ulcer; Prospective Studies; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

The authors, after a short introduction of physiopathology, report on 17 patients who underwent a total (10 cases) or a subtotal (7 cases) gastrectomy for cancer at various times and then submitted to hemochromocytometric test and Schilling test modified by Katz and Bell. On the bases of information given by the tests, some clinical and therapeutic considerations are made.

Topics: Carcinoma, Squamous Cell; Female; Gastrectomy; Humans; Malabsorption Syndromes; Male; Schilling Test; Stomach Neoplasms; Vitamin B 12

The fat, protein and B12 absorption by the liver, kidney and small intestine was studied by radionuclide methods in gastric cancer patients during the preoperative period as well as within 15-30 days, 3-12 months and for more than a year following gastrectomy. It was observed that the function of the kidney, liver and B12 absorption was disturbed during the preoperative period. Gastrectomy caused a marked depression of the renal, hepatic and small intestinal function. During later periods following gastrectomy, these functions improved but were not restored to normal.

Topics: Follow-Up Studies; Humans; Intestinal Absorption; Intestine, Small; Kidney; Lipid Metabolism; Liver; Postgastrectomy Syndromes; Proteins; Radionuclide Imaging; Stomach Neoplasms; Vitamin B 12

Topics: Aged; Aminosalicylic Acid; Anemia, Macrocytic; Anemia, Megaloblastic; Anticonvulsants; Antineoplastic Agents; Colchicine; Humans; Hydroxocobalamin; Intestinal Absorption; Neomycin; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Age Factors; Duodenal Ulcer; Gastric Mucosa; Gastritis, Atrophic; Gastroenterostomy; Humans; Intestinal Polyps; Iron; Male; Middle Aged; Postoperative Complications; Precancerous Conditions; Stomach Neoplasms; Time Factors; Vitamin B 12

Topics: Carcinoma, Hepatocellular; Carrier Proteins; Fibroma; Gallbladder Neoplasms; Hemangioma, Cavernous; Humans; Lipoma; Liver Neoplasms; Male; Middle Aged; Neoplasms, Multiple Primary; Stomach Neoplasms; Vitamin B 12

Twenty-seven cases of long-term survival after total gastrectomy were clinically evaluated. From the standpoint of general nutrition and rehabilitation, the patients appeared to be in satisfactory condition. However, hyperchromic anemia, serum vitamin B12 deficiency, and osteoporosis were noted in some patients.

Topics: Adult; Aged; Anemia; Body Weight; Bone and Bones; Gastrectomy; Humans; Japan; Middle Aged; Nutritional Physiological Phenomena; Osteoporosis; Postgastrectomy Syndromes; Postoperative Care; Radiography; Stomach Neoplasms; Vitamin B 12

Topics: Cobalt Radioisotopes; Gastrectomy; Humans; Intestinal Absorption; Postoperative Period; Stomach Neoplasms; Vitamin B 12

Only a small proportion of patients with carcinoma of the stomach are suitable for radical surgery. For the remainder symptomatic treatment and radiotherapy alone or in combination with chemotherapy can be used to relieve distressing symptoms of pain, nausea and vomiting, and severe anemia. In the case of radiotherapy or chemotherapy, a degree of tumor regression can be expected. There have been encouraging results recently in palliating this disease with new radiotherapy techniques, notably fast neutron irradiation.

Topics: Analgesics; Anemia; Antacids; Carbenoxolone; Cortisone; Dexamethasone; Diet Therapy; Fast Neutrons; Humans; Iron; Parasympatholytics; Stomach Neoplasms; Vitamin B 12

The transplantable argyrophilic gastric carcinoids producing histamine found in Praomys (Mastomys) natalensis contained no significant amount of vitamin B12-binding proteins. It was also demonstrated that the concentration of vitamin B12-binding proteins in glandular stomach of mastomys was much lower than those in the same tissues of the rat or mouse.

Topics: Animals; Carcinoid Tumor; Carrier Proteins; Humans; Intrinsic Factor; Mice; Neoplasms, Experimental; Rats; Rodentia; Stomach Neoplasms; Vitamin B 12

200 consecutive patients operated on for gastric (GU) or duodenal (DU) ulcer in 1956 to 1957 were followed up until 1974. 25 of them died within five years of primary operation and were excluded to eliminate the possibility of coexisting ulcer and malignancy at the time of operation. Four patients could not be traced and 65 died within the follow-up period, but none of them of gastric carcinoma. 46 out of 106 living patients came for re-examination and gastroscopy was performed in 42 of them. The remaining 60 patients were examined by questionnaire. According to the Finnish Cancer Registry none of them had gastric carcinoma. The expected number of gastric carcinomas in the present series was calculated to be 2.3 and of all malignancies 13.6, but only one gastric carcinoma and 19 other malignancies were detected. The gastric carcinoma detected endoscopically and verified bioptically and cytologically was microscopically of anaplastic type. Most of the patients were in excellent general condition without gastric complaints. The present series reveals no clearcut causal relationship between gastric resection and late development of stump carcinoma.

Topics: Adult; Aged; Calcium; Duodenum; Female; Finland; Follow-Up Studies; Gastrectomy; Hemoglobins; Humans; Iron; Jejunum; Male; Middle Aged; Peptic Ulcer; Postoperative Complications; Stomach Neoplasms; Vitamin B 12

Topics: Adult; Aged; Colonic Neoplasms; Female; Fluorouracil; Gastrointestinal Neoplasms; Humans; Male; Methenolone; Middle Aged; Rectal Neoplasms; Stomach Neoplasms; Vitamin B 12; Vitamin B Complex

Fasting serum pyridoxal was assayed by an automated microbiological system in 60 patients investigated for dyspepsia, patients with active peptic ulceration being excluded from the study. Gastritis was present in 30 patients, gastric carcinoma in 16, six patients had benign polyps, and, in eight patients, radiology, endoscopy, and biopsy failed to shown any abnormality. Of the 52 patients with gastric pathology, 44 had a low serum pyridoxal.

Topics: Adult; Aged; Biopsy; Endoscopy; Female; Folic Acid; Gastritis; Humans; Intestinal Polyps; Male; Middle Aged; Pyridoxal; Radiography; Stomach Diseases; Stomach Neoplasms; Vitamin B 12

Elevation of transcobalamin I and serum vitamin B12 levels has usually been associated with increased granulocytic proliferation, such as occurs in chronic myelogenous leukemia. Two patients with metastatic cancer had extremely high serum vitamin B12 and transcobalamin I levels--greater than those seen in even the most intense granulocytic proliferation--that were not explainable by leukocytosis. The subjects' serum vitamin B12 levels were 18,750 and 21,221 pg per milliliter (normal, 471 plus or minus 174 pg per milliliter, mean plus or minus S.D.) and unsaturated vitamin B12 binding capacity 158,750 and 5,400 pg per milliliter (normal, 1153 plus or minus 313 pg per milliliter) respectively. The abnormally elevated serum binder was shown to be identical with transcobalamin balamin I in every respect. Levels of transcobalamin II and serum third binder were normal. The cause of the binder abnormality is unknown, but factors other than granulocyte proliferation may control or contribute to the production or accumulation of transcobalamin I.

Topics: Adenocarcinoma; Aged; Animals; Blood Proteins; Carcinoma; Carrier Proteins; Cell Division; Chromatography, DEAE-Cellulose; Chromatography, Gel; Cobalt Radioisotopes; Colonic Neoplasms; Female; Granulocytes; Humans; Immune Sera; Leukemia, Myeloid; Leukocyte Count; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Neoplasm Metastasis; Neoplasms; Protein Binding; Rabbits; Radioligand Assay; Saliva; Stomach Neoplasms; Vitamin B 12

Topics: Anemia, Pernicious; Humans; Intrinsic Factor; Leiomyoma; Male; Middle Aged; Muscle, Smooth; Remission, Spontaneous; Schilling Test; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency; Vitiligo

Topics: Female; Gastrectomy; Humans; Intestinal Absorption; Male; Peptic Ulcer; Stomach; Stomach Neoplasms; Vitamin B 12

Topics: Adult; Aged; Anemia, Pernicious; Female; Gastric Mucosa; Gastroscopy; Humans; Male; Middle Aged; Neoplasm Regression, Spontaneous; Photography; Polyps; Radiography; Stomach; Stomach Neoplasms; Time Factors; Vitamin B 12

Topics: Animals; Buffers; Chlorides; Cobalt Isotopes; Dogs; Duodenal Ulcer; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Glycine; Humans; Osmolar Concentration; Pentagastrin; Peptic Ulcer; Potassium; Pyloric Antrum; Pylorus; Sodium; Stimulation, Chemical; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12; Wound Healing

Topics: Adenocarcinoma; Female; Follow-Up Studies; Gastrectomy; Humans; Male; Middle Aged; Prognosis; Stomach Neoplasms; Vitamin B 12

Topics: Atrophy; Biopsy; Carcinoma; Cobalt Isotopes; Gastric Acidity Determination; Gastric Mucosa; Gastroscopy; Humans; Staining and Labeling; Stomach Diseases; Stomach Neoplasms; Vitamin B 12

Topics: Adult; Age Factors; Aged; Alcohol Drinking; Duodenal Ulcer; Erythrocytes; Follow-Up Studies; Gastrectomy; Gastric Juice; Humans; Intrinsic Factor; Leiomyoma; Methods; Middle Aged; Pepsin A; Postoperative Complications; Schilling Test; Stomach Neoplasms; Stomach Ulcer; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

The prevalence of circulating antibodies to gastric intrinsic factor and parietal cells was examined in 60 patients with histologically proven gastric carcinoma and was found not to differ from the prevalence of these antibodies in control subjects of similar age and sex distribution.Amongst the 60 patients with gastric carcinoma seven were thought to have actual or potential pernicious anaemia. The absence of an increased prevalence of antigastric antibodies in gastric carcinoma indicates that gastritis itself, whether autoimmune or not, is the likely common denominator underlying the predisposition to gastric carcinoma in both pernicious anaemia and chronic atrophic gastritis.

Topics: Adolescent; Adult; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Child; Female; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Precancerous Conditions; Stomach; Stomach Neoplasms; Vitamin B 12

Gastric carcinoma was detected nine, 10, 18, and 21 years after the biopsy diagnosis of atrophic gastritis in four patients of a group of 40. The gastritis was presumed to be of the simple type. Tests of vitamin B(12) absorption in three patients gave normal results, no gastric autoantibodies were detected in the two patients tested, in all patients histological examination of the gastrectomy specimens revealed a multifocal gastritis differing from the diffuse gastritis of pernicious anaemia and in three patients the gastritis affected the antrum, which is unusual in pernicious anaemia. The 10% incidence of gastric carcinoma in 40 patients with simple atrophic gastritis followed for a mean period of 15 years is equivalent to that previously described in pernicious anaemia. However, in view of the relative incidence of atrophic gastritis with and without pernicious anaemia in the general adult population, it emerges that atrophic gastritis without pernicious anaemia is numerically the more important precursor of gastric carcinoma.

Topics: Adult; Anemia, Pernicious; Atrophy; Autoantibodies; Biopsy; Female; Follow-Up Studies; Gastrectomy; Gastritis; Humans; Intestinal Absorption; Male; Middle Aged; Precancerous Conditions; Pylorus; Stomach Neoplasms; Vitamin B 12

Topics: Adult; Age Factors; Aged; Cyclophosphamide; Female; Humans; Injections, Intravenous; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Lung Neoplasms; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Male; Middle Aged; Multiple Myeloma; Ovarian Neoplasms; Sex Factors; Stomach Neoplasms; Vitamin B 12; Xylose

Topics: Absorption; Adult; Aged; Bone Marrow Cells; Calcium; Esophageal Neoplasms; Feces; Female; Folic Acid; Gastrectomy; Gastroscopy; Hematocrit; Hemoglobins; Humans; Iron; Lipid Metabolism; Liver Function Tests; Male; Middle Aged; Phosphorus; Schilling Test; Stomach; Stomach Neoplasms; Transferases; Vitamin B 12

Topics: Adult; Chronic Disease; Crohn Disease; Diagnosis, Differential; Gastric Juice; Gastritis; Humans; Ileum; Intestinal Mucosa; Male; Middle Aged; Polyps; Stomach; Stomach Diseases; Stomach Neoplasms; Vitamin B 12

Topics: Achlorhydria; Aged; Anemia, Pernicious; Antibody Formation; Autoantibodies; Female; Fluorescent Antibody Technique; Gastric Acidity Determination; Gastric Juice; Histamine Release; Humans; Intrinsic Factor; Male; Middle Aged; Schilling Test; Stomach Neoplasms; Vitamin B 12

Topics: Cobalt Isotopes; Duodenal Ulcer; Gastritis; Humans; Intestinal Absorption; Peptic Ulcer; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Anemia, Hypochromic; Cobalt Isotopes; Duodenal Ulcer; Female; Gastrectomy; Humans; Intrinsic Factor; Iron; Male; Peptic Ulcer; Postgastrectomy Syndromes; Schilling Test; Stomach Neoplasms; Vitamin B 12

Topics: Aged; Amylases; Blood Proteins; Calcium; Female; Follow-Up Studies; Gastrectomy; Gastric Acidity Determination; Hemoglobins; Humans; Hydrogen-Ion Concentration; Intestinal Absorption; Iron; Lipase; Male; Middle Aged; Pancreas; Pancreatic Juice; Phosphorus; Stomach; Stomach Neoplasms; Transferrin; Trypsin; Vitamin B 12

Topics: Anemia, Pernicious; Antibodies; Cobalt Isotopes; Gastritis; Humans; Intrinsic Factor; Stomach Neoplasms; Vitamin B 12

Topics: Adolescent; Adult; Aged; Analysis of Variance; Anemia, Pernicious; Carbachol; Cobalt Isotopes; Female; Gastric Juice; Histamine; Humans; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Male; Middle Aged; Schilling Test; Stomach Neoplasms; Vitamin B 12

Topics: Cobalt Isotopes; Gastric Juice; Humans; Intestinal Absorption; Iron Isotopes; Mathematics; Radiometry; Spectrometry, Gamma; Stomach Neoplasms; Vitamin B 12

Topics: Blood Proteins; Copper; Digestive System; Dumping Syndrome; Duodenum; Follow-Up Studies; Gastrectomy; Humans; Iron; Lipids; Liver; Methods; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Aged; Calcium; Calcium Isotopes; Fats; Female; Gastrectomy; Humans; Intestinal Absorption; Iron; Male; Middle Aged; Pancreas; Stomach Neoplasms; Vitamin B 12

Topics: Anemia, Pernicious; Animals; Antibodies; Cobalt Isotopes; Gastric Juice; Haplorhini; Humans; Immunoassay; Intrinsic Factor; Peptic Ulcer; Protein Binding; Rats; Species Specificity; Stomach Neoplasms; Swine; Vitamin B 12

Topics: Ataxia; Gastrectomy; Humans; Male; Middle Aged; Postgastrectomy Syndromes; Postoperative Complications; Spinal Cord Diseases; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia, Pernicious; Biopsy; Follow-Up Studies; Gastric Mucosa; Gastritis; Gastroscopy; Hemoglobins; Humans; Metaplasia; Radiography; Schilling Test; Stomach; Stomach Neoplasms; Vitamin B 12

Topics: Aged; Anemia, Pernicious; Female; Humans; Radiography; Spasm; Stomach Neoplasms; Vitamin B 12

Topics: Aged; Female; Follow-Up Studies; Humans; Male; Middle Aged; Polyps; Postoperative Complications; Stomach Neoplasms; Vitamin B 12

Topics: Corrinoids; Gastrectomy; Hematinics; Humans; Intestinal Absorption; Stomach Neoplasms; Vitamin B 12; Vitamins

Topics: Adult; Aged; Anemia, Pernicious; Antibodies; Cobalt Isotopes; Gastric Acidity Determination; Gastritis; Histamine; Humans; Immunoassay; Intrinsic Factor; Middle Aged; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Adult; Female; Humans; Male; Middle Aged; Niacinamide; Pantothenic Acid; Pyridoxine; Stomach Neoplasms; Vitamin B 12

Topics: Anemia, Pernicious; Biomedical Research; Corrinoids; Diagnosis, Differential; Gastritis; Humans; Intrinsic Factor; Research; Stomach Neoplasms; Vitamin B 12

Topics: Adrenocorticotropic Hormone; Corrinoids; Desoxycorticosterone; Diet; Esophageal Neoplasms; Gastrointestinal Neoplasms; Hematinics; Humans; Nandrolone; Neoplasms; Palliative Care; Stomach Neoplasms; Thiamine; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Animals; Cobalt Isotopes; Electrophoresis; Gastrectomy; Gastric Juice; Gastric Mucosa; Guinea Pigs; Histamine; In Vitro Techniques; Intestinal Mucosa; Intrinsic Factor; Pathology; Peptic Ulcer; Rats; Research; Saliva; Stomach Neoplasms; Urine; Vagus Nerve; Vitamin B 12

Topics: Corrinoids; Cytodiagnosis; Early Diagnosis; Fluorescence; Gastric Lavage; Humans; Microscopy; Microscopy, Fluorescence; Neoplasms; Stomach Neoplasms; Urine; Vitamin B 12

Topics: Deficiency Diseases; Diagnostic Tests, Routine; Diet; Diet Therapy; Dumping Syndrome; Humans; Intestinal Absorption; Malnutrition; Oleic Acid; Peptic Ulcer; Postgastrectomy Syndromes; Stomach Neoplasms; Surgical Procedures, Operative; Suture Techniques; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Gastrectomy; Humans; Postgastrectomy Syndromes; Stomach Neoplasms; Vitamin B 12

Topics: Adenocarcinoma; Anemia; Anemia, Pernicious; Biological Assay; Blood; Cobalt Isotopes; Gastrectomy; Gastric Acidity Determination; Geriatrics; Histamine; Humans; Intrinsic Factor; Lactobacillus; Liver; Lymphoma; Schilling Test; Stomach Neoplasms; Urine; Vitamin B 12

Topics: Atrophy; Duodenal Ulcer; Gastritis; Gastritis, Atrophic; Humans; Intrinsic Factor; Polyps; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Biochemical Phenomena; Humans; Liver; Serum; Stomach Neoplasms; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Cobalt; Gastric Juice; Humans; Stomach; Stomach Neoplasms; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Gastric Juice; Hematinics; Humans; Stomach Neoplasms; Vitamin B 12

Topics: Anemia; Anemia, Macrocytic; Corrinoids; Folic Acid; Hematinics; Humans; Linitis Plastica; Stomach Diseases; Stomach Neoplasms; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Corrinoids; Stomach; Stomach Neoplasms; Vitamin B 12