The association between webs, iron and post-cricoid carcinoma

Abstract

SummaryThe association of iron deficiency anaemia, postcricoid webs and carcinoma is controversial. The main findings in a recent study which re-examined this problem are presented here. It was shown that the majority of patients with a post-cricoid web have evidence of iron deficiency but that only about 10°O of patients with iron deficiency develop post-cricoid webs. Factors which might be important in the pathogenesis of a post-cricoid web have been looked for and a few significant points noted. The main findings were an increased frequency of angular stomatitis and edentia, thyroid disease and thyroid cytoplasmic antibodies in patients with webs compared with patients with iron deficiency anaemia without a web.Follow-up studies in patients with a post-cricoid web or Paterson-Kelly syndrome show an increased frequency of post-cricoid carcinoma ranging from 4 to 16%/ in different series and the association is even more striking in patients presenting with post-cricoid carcinoma. It is concluded that the available evidence confirms the association between iron deficiency, postcricoid webs and carcinoma but the mechanism of the production of these changes is not yet understood.

Síndrome de plummer-vinson: relato de caso

“…Dão suporte a essa teoria, sobretudo, a presença de ferropenia na síndrome e a melhora clínica e endoscópica à reposição desse elemento. [16][17][18] Entretanto, o papel preciso da deficiência de ferro no desenvolvimento da síndrome ainda está por ser definido. 19 Sabe-se que o trato gastrintestinal é susceptível à ferropenia, dada sua elevada taxa de renovação celular com enzimas dependentes de ferro.…”

“…19 Sabe-se que o trato gastrintestinal é susceptível à ferropenia, dada sua elevada taxa de renovação celular com enzimas dependentes de ferro. Dessa forma, é possível que tal alteração promova degradação da mucosa e formação de membranas, 16,17 bem como alteração na contração muscular por degradação progressiva dos músculos da faringe devido à redução de enzimas oxidativas ferro-dependentes. 20 Por outro lado, nem todos os pacientes têm deficiência de ferro.…”

Gastric Cancer Occurring in a Patient with Plummer-Vinson Syndrome: A case report

“…Pathologic finding of upper esophageal web shows hypertrophy or atrophy of squamous cells and it is sometimes combined with chronic inflammation [1] . Plummer-Vinson syndrome is known to be associated with an increased risk of upper alimentary tract cancers, and the incidence rate of upper esophageal cancer in this syndrome is 3-15% [6] . In Sweden, the incidence of upper alimentary tract cancer and hypopharyngeal cancer in Plummer-Vinson syndrome is decreasing along with that of the syndrome itself [3] .…”

“…Moreover, this syndrome is now thought to be associated with the deficient intake of vitamins and iron [1,3,4] . Most patients are women aged over 40 years, and this group accounts for 75% in number [5,6] . The syndrome is usually asymptomatic, but the patients sometimes develop dysphagia, weight loss, and weakness.…”

Role of Microsatellites Instability in Carcinogenesis of Postcricoid Carcinoma on Top of Plummer-Vinson Syndrome

“…The reported incidence of upper aero-digestive tract carcinoma in PVS was between 4 and 16% and almost occurred in postcricoid region [4]. Other documented sites included the oral cavity, esophagus, stomach and pyriform fossa [5][6][7].…”