title: [Gastric adenocarcinoma: approach to a complex biological reality].
abstract: The authors review the complex biological reality of gastric adenocarcinoma from several viewpoints. It is a neoplasm histologically expressed as a dual process (intestinal and diffuse types) with a broad cytological diversity. From an epidemiological point of view, it behaves as an entity with a deep geographical asymmetry and a changing incidence, currently decreasing. There is a multifactorial etiology with a combination of genetic, infectious (H. pylori), nutritional and environmental factors. It might have a multiphasic gestation from precancerous lesions, though not always following a lineal sequence. We only know fragmentary portions of its pathogenesis whose common denominator is a potentially mutagenic mitogenic activation of the epithelial cells implicated. A good knowledge of this complex biological reality will allow the identification of better markers for an early diagnosis as well as vulnerable etiopathogenetic points for a useful prevention and therapy.
authors.affiliation: Servicio de Aparato Digestivo, Fundación Jiménez Díaz, Universidad Autónoma, Avenida Reyes Católicos 2, 28040 Madrid, Spain. psanche@jfd.es
authors.forename: Paloma
authors.initials: P
authors.lastname: Sánchez-Fayos
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Martín Relloso
authors.forename: Agustina
authors.initials: A
authors.lastname: González Guirado
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Porres Cubero
mesh_terms: D000126:Achlorhydria / Q000150:complications; D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000235:genetics / Q000473:pathology; D000368:Aged; D004032:Diet / Q000009:adverse effects; D042241:Early Diagnosis; D004847:Epithelial Cells / Q000166:cytology / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005757:Gastritis, Atrophic / Q000150:complications; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D008938:Mitosis; D011230:Precancerous Conditions / Q000139:chemically induced / Q000473:pathology; D012307:Risk Factors; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000235:genetics / Q000473:pathology