Ioannis Kakkas, Greece
Evaggelismos General Hospital Immunology & HistocompatibilityPresenter of 1 Presentation
GASTRIC CANCER IN COMMON VARIABLE IMMUNODEFICIENCY: A SINGLE CENTER EXPERIENCE
Abstract
Background and Aims
Common Variable Immunodeficiency (CVID) patients are prone to autoimmune disorders, granulomatous disease and malignancies (mostly aggressive lymphomas and neoplasms of the gastrointestinal tract). In CVID patients the main histological type of gastrointestinal tract neoplasms, according to various publications, is adenocarcinoma of the stomach (Gastric Cancer, GC). In these studies, the risk of GC in CVID patients was estimated to be 1% and less. The aim of this study was to investigate the incidence of GC in our adult CVID patients.
Methods
Between 1972 and 2018, 90 CVID adult patients were diagnosed in our hospital. Thirty of them were lost in follow up. In this study we describe eight cases of adult CVID patients (8/60, 13%), who developed GC.
Results
Four of these patients were male and four of them female. Their age at diagnosis of GC ranged between 42 and 70 years (median: 58 years). CVID had been identified several years before the diagnosis of GC. Pernicious anemia and atrophic gastritis were identified in four patients before GC diagnosis. Helicobacter Pylori infection (HP) was diagnosed in all three patients investigated for this infection. All eight patients underwent total gastrectomy. Currently, three of them are alive under immunoglobulin substitution treatment.
Conclusions
Conclusively, it is obvious that the incidence of gastric cancer in our CVID patients is much higher (13%) than that reported in other studies (1% and less). Probably, this fact is related to our patients’ age (exclusively adults), as atrophic gastritis and HP infection play an aggravating role in GC development.