Epidemiologic Pathology of Gastric Ulcer and Gastric Carcinoma Among Japanese in Hawaii

This case-control study of Hawaiian Japanese indicated that gastric ulcer in the proximal portion of the pyloric antrum has features similar to those of gastric cancer. Such ulcers occurred at sites most frequently and most severely affected by intestinal metaplasia, although metaplasia tended to be...

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Bibliographic Details
Published in:JNCI : Journal of the National Cancer Institute 1977-01, Vol.58 (1), p.13-20
Main Authors: Stemmermann, G., Haenszel, W., Locke, F.
Format: Article
Language:English
Subjects:
ABO Blood-Group System
Aged
Diet - adverse effects
Female
Hawaii
Humans
Japan - ethnology
Male
Metaplasia
Middle Aged
Pyloric Antrum
Retrospective Studies
Smoking
Socioeconomic Factors
Sodium Chloride - adverse effects
Stomach Neoplasms - complications
Stomach Neoplasms - etiology
Stomach Neoplasms - pathology
Stomach Ulcer - complications
Stomach Ulcer - etiology
Stomach Ulcer - pathology
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Summary:This case-control study of Hawaiian Japanese indicated that gastric ulcer in the proximal portion of the pyloric antrum has features similar to those of gastric cancer. Such ulcers occurred at sites most frequently and most severely affected by intestinal metaplasia, although metaplasia tended to be more extensive with cancer than with ulcer. Metaplastic mucosa was more vulnerable to the action of pepsin and acid than was normal mucosa. The risk of ulceration would rise when a sufficiently large area of the antrum was intestinalized and when the corpus continued to produce significant quantities of these substances. This study showed a strong association between salt intake, ulcer, and metaplasia. Significant but less dramatic associations were demonstrated between metaplasia and the use of traditional Japanese foods and smoking. The question was raised as to whether salt promotes ulceration or whether it potentiates the action of a mutagen that causes intestinal metaplasia.
ISSN:0027-8874
1460-2105
DOI:10.1093/jnci/58.1.13