Chebib I, Beck P L, Church N G, Medlicott S A C
Department of Laboratory Medicine, Peter Lougheed Centre, Calgary, AB, Canada.
Obes Surg. 2007 Jun;17(6):843-6. doi: 10.1007/s11695-007-9130-2.
There are reports of gastric carcinoma following bariatric surgery, but it is unclear if these procedures predispose to malignancy. We present a case of a 60-year-old man who, 15 years after vertical banded gastroplasty (VBG), had a massive upper GI bleed. Endoscopy revealed a large tumor of the gastric pouch. Histology confirmed an intestinal type of gastric adenocarcinoma arising in a background of H. pylori-negative gastritis with atrophy, foveolar hyperplasia and intestinal metaplasia. An incidental tubular adenoma at the pylorus was also identified. The pathogenesis of gastric pouch carcinoma is discussed. The present example of neoplastic change in both the pouch and pylorus may indicate that a field effect for dysplasia develops subsequent to VBG.
有关于减肥手术后发生胃癌的报道，但尚不清楚这些手术是否易引发恶性肿瘤。我们报告一例60岁男性患者，在垂直束带胃成形术（VBG）15年后发生大量上消化道出血。内镜检查发现胃囊有一个大肿瘤。组织学证实为肠型胃腺癌，其发生于幽门螺杆菌阴性的萎缩性胃炎、小凹上皮增生和肠化生背景中。同时还发现幽门处有一个偶然的管状腺瘤。本文讨论了胃囊癌的发病机制。胃囊和幽门均发生肿瘤性改变的当前病例可能表明，VBG后会出现发育异常的场效应。
