Lewis J H, Woods M
Am J Gastroenterol. 1982 Jun;77(6):368-73.
Gastric cancer may develop in the presence of active or chronic duodenal ulcer disease in the unoperated stomach. This association is considered rare, especially since the presence of a duodenal ulcer is believed to protect against the development of a gastric malignancy. In this review, we describe two patients in whom gastric cancer was diagnosed after a long history of duodenal ulcer disease. Also presented is a review of 236 additional cases from the literature Patients with gastric cancer associated with duodenal ulcer disease tended to be younger than patients who develop gastric cancer not associated with duodenal ulcer. When compared to patients with gastric remnant (stump) cancer, the latency from onset of ulcer symptoms to the diagnosis of gastric cancer was shorter than the latency for stump cancer development, but the risk of developing stump cancer appears to be greater. The natural history and prognosis of this entity is otherwise similar to gastric cancer unassociated with duodenal ulcer and to stump cancer. A change in ulcer symptoms is an insensitive clue to the presence of gastric cancer in this group. The diagnosis may be delayed in some individuals whose gastric cancers respond to cimetidine or other agents.
在未接受手术的胃中，胃癌可能在活动性或慢性十二指肠溃疡疾病存在的情况下发生。这种关联被认为很罕见，尤其是因为十二指肠溃疡的存在被认为可预防胃恶性肿瘤的发生。在本综述中，我们描述了两名有长期十二指肠溃疡病史后被诊断为胃癌的患者。此外还对文献中另外236例病例进行了综述。与未合并十二指肠溃疡的胃癌患者相比，合并十二指肠溃疡疾病的胃癌患者往往更年轻。与胃残端（吻合口）癌患者相比，从溃疡症状出现到胃癌诊断的潜伏期比残端癌发生的潜伏期短，但发生残端癌的风险似乎更大。该实体的自然病史和预后与未合并十二指肠溃疡的胃癌以及残端癌相似。在这组患者中，溃疡症状的改变对于胃癌的存在是一个不敏感的线索。对于某些胃癌对西咪替丁或其他药物有反应的个体，诊断可能会延迟。
