The GI tract

6 important questions on The GI tract

What damage is caused by auto-immune gastritis?

- Intestinal metaplasia
- Neuro-endocrine cell hyperplasia
- Anemia (because intrinsic factor is needed for B12 uptake, and B12 uptake is needed for red blood cell production)

What are the steps of the development of a gastric adenocarcinoma?

Chronic gastritis → Intestinal metaplasia → Dysplasia → Gastric adenocarcinoma

What are the two types of gastric adenocarcinoma?

- The intestinal type: glands are still being formed
- The diffuse type: thick stomach wall, no glands are being formed, the cells have lost their adhesion molecules and the tumor is diffused in the whole stomach.
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What is the 'old-fashioned' screening method like?

If a polyp was found, it was removed (although just 5% of them progress to adenocarcinoma).
However, this is quite invasive.

What could be ways in which the adenomas with highest risk of progression to adenocarcinomas are selected?

- Size: bigger adenomas do have higher risk on progressing to adenocarcinomas -- you however still miss many possible carcinomas.
- Histological type: maybe potential for the future, but too risky now.
- Grade of dysplasia: you would miss the majority.
- Chromosomal abnormalities: some are very common in colorectal cancer, but in screening considered to be too difficult.

Which of the before-mentioned ways of selecting the high-risk adenomas is very promising?

- The screening on chromosomal abnormalities, as some point mutations are found in many adenocarcinomas, which could be used as a biomarker (so looking for certain proteins in a cell, when they are there, it is very likely to be cancerous).
- This has not yet been implemented.

The question on the page originate from the summary of the following study material:

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