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Cancer Genetics

Gastric Adenocarcinoma with Signet Rings Cell

01/11/2011

Question:

I am a female, 34 years old and last year I was diagnosticated with an early gastric cancer, adenocarcinoma of antrum, signet rings cells, T1A, M0, N0 (0/32), V0, G3. I make a subtotal gastrectomy, with limfadenectomy. After a year from surgery, all my analyses are wel. I don/t know about a familiy history with gastric cancer, breast cancer or colon cancer but I don t know if in these conditon, my age and type of malignant cell can be risk factors for ereditary gastric cancer and maybe is better to try genetic analyses. If it is a gentic condition in my case the precent of rate for survival or time for a relapse is modified compared with non genetic cancer? My surgeon say me that the probability to relapse is under 10% because was an early stage. If it is a genetic condition this probability may be different? Thank you very much.

Answer:

Because of your age and the type of gastric cancer you had (signet ring cell), a genetic analysis would be a good idea, even though you do not have a family history of anyone with other cancers. This kind of gastric cancer is more commonly found in people with a hereditary cancer susceptibilty syndrome called "hereditary diffuse gastric cancer" (HDGC). People with HDGC have a hight risk for gastric cancer, and women with this have an increased risk for breast cancer, specifically a less common type called lobular carcinoma. HDGC is caused by changes that interfere with the function ("mutations") of a gene called E-cadherin (abreviated CDH-1). If you are found to have a change in this gene, other members of your family should consider genetic testing to find out whether they may have also inherited this change. THere are some ways to reduce cancer risk for people with inherited forms of gastric cancer.

It is not clear in the scientific literature whether the risk of recurrence is different between people who have hereditary forms of gastric cancer compared to those who have sporadic gastric cancer. Your surgeon is the best resource with whom to discuss this.

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Response by:

Duane D Culler, PhD, MS Duane D Culler, PhD, MS
Clinical Instructor of Genetics
School of Medicine
Case Western Reserve University