Abstract:Background. This retrospective study was carried out to review our surgical experience and to define the clinicopathologic profile of early gastric cancer in a Western country with one of the highest incidences in the world. Methods. Fifty-eight patients who had gastric surgery for early gastric cancer were included in this study. Results. The incidence of early gastric cancer was 13.9% of the patients with resected gastric cancer (58/416). The mean age of these 58 patients at diagnosis was 56.8 ؎ 12.3 years (range, 30-81 years) and the male : female ratio was 2.4 : 1. The most common presenting symptom was epigastric pain (52.4%). All patients were treated by surgical resection. Tumors were typically located in the antrum (72.4%), with a predominance of lesser curvature lesions (89.7%). Macroscopically, the majority of the lesions (63.8%) were excavated (types IIc and III). Thirty tumors were intramucosal and 28 extended into the submucosa. Thirty were of the intestinal type and 28 of the diffuse type. The rate of regional lymph node metastasis was 10.4%. The overall 5-year survival rate was 93.9%. Conclusions. The excellent response to surgical resection of early gastric cancer reported by Japanese authors is reproducible in Western countries even in the presence of regional lymph node metastasis. For this reason an aggressive surgical approach should be taken for all early gastric cancer.

BackgroundGastric cancer (GC) is one of the most common malignant tumors of the digestive tract and is the third leading cause of cancer death worldwide. Epstein–Barr virus (EBV) has been associated with approximately 10% of the total cases of gastric carcinomas. No previous study has analyzed the prevalence of EBV infection in gastric cancer of the Portuguese population.MethodsIn the present study, we have analyzed 82 gastric carcinoma cases and 33 healthy individuals (control group) from Coimbra region for the presence of EBV by polymerase chain reaction (PCR) and by in situ hybridization (ISH) for EBV-encoded small RNAs (EBERs). The status of H. pylori infection was assessed by serology and by PCR.ResultsEBV was detected by PCR in 90.2% of stomach cancer cases, whereas EBERs were detected in 11%. In our series, EBV-associated gastric carcinoma (EBVaGC) were significantly associated with gender and the majority of them presented lymph node metastasis. These cases were generally graded in more advanced pTNM stages and, non-surprisingly, showed worse survival. H. pylori infection was detected in 62.2% of the gastric cancers and 64.7% of these patients were CagA+. On the other hand, the H. pylori prevalence was higher in the EBV-negative gastric carcinomas (64.4%) than in those carcinoma cases with EBV+ (44.4%).ConclusionsThe present study shows that prevalence of EBVaGC among Portuguese population is in accordance with the worldwide prevalence. EBV infection seems to be associated to poorer prognostic and no relation to H. pylori infection has been found. Conversely, the presence of H. pylori seems to have a favourable impact on patient’s survival. Our results emphasize that geographic variation can contribute with new epidemiological data on the association of EBV with gastric cancer.

A systematic search was conducted comparing the Hounsfield units (HU) value obtained from computed tomography and the T-score of dual-energy X-ray absorptiometry (DXA) in the prediction of the lumbar spine bone mineral density (BMD). Current data evidences favorable results regarding the possibility of establishing a threshold value for osteoporosis diagnosis from CT measurements of HU.

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