New Perspectives in Gastric Cancer: Helicobacter pylori-Uninfected Pure Signet Ring Cell Carcinoma
Although gastric cancer incidence and mortality rates remain high in Japan, they have decreased in recent years. This decline is thought to be attributable to the reduction of Helicobacter pylori (HP) infection rate (approximately 50% of the population born in the 1940s vs. 10% in the 1980s). However, some studies on HP-uninfected gastric cancer have reported that the prevalence of this type of cancer accounted for 5% at most. HP-uninfected gastric cancers include lesions related to autoimmune gastritis, Epstein–Barr virus infection, genetic factors such as hereditary diffuse gastric cancer (HDGC), and sporadic/nonhereditary cancers. Among sporadic HP-uninfected gastric cancers, pure signet ring cell carcinomas are reported to be the most common. In this chapter, clinicopathological characteristics of this type of cancer are discussed, compared with a case of HDGC. And speculation about the carcinogenic mechanisms (mainly focusing on CDH1 gene alteration) based on the evidences obtained from previous excellent mouse models are also introduced here.
KeywordsHelicobacter pylori-uninfected gastric cancer Signet ring cell carcinoma E-cadherin CDH1 gene alteration
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