Gastric Acidity Before and After Development of Gastric Cancer: Its Etiologic, Diagnostic and Prognostic Significance

Article1 June 1951GASTRIC ACIDITY BEFORE AND AFTER DEVELOPMENT OF GASTRIC CANCER: ITS ETIOLOGIC, DIAGNOSTIC AND PROGNOSTIC SIGNIFICANCEMANDRED W. COMFORT, M.D., F.A.C.P.MANDRED W. COMFORT, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-34-6-1331 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptEveryone knows that in gastric cancer the mean gastric secretory activity is subnormal, but to what extent is it subnormal? What factors influence gastric acidity in gastric cancer? Does cancer develop in stomachs that already have subnormal gastric acidity, or does gastric secretory function become subnormal after cancer develops? What process is responsible for lowered gastric secretion? Finally, of what diagnostic and prognostic value is the degree of gastric secretory activity?In the past two decades, many facts bearing on these questions have been recorded. These data will be summarized.GASTRIC SECRETION IN NORMAL PERSONSSurvey of data from normal...Bibliography1. VanzantAlvarezEustermanDunnBerkson FRWCGBHLJ: The normal range of gastric acidity from youth to old age: an analysis of 3,746 records, Arch. Int. Med. 49: 345-359, 1932. CrossrefGoogle Scholar2. RuffinDick JMM: The significance of gastric acidity after histamine stimulation: a statistical study of 2,877 gastric analyses, Ann. Int. Med. 12: 1940-1947, 1939. LinkGoogle Scholar3. Polland WS: Histamine test meals: an analysis of nine hundred and eighty-eight consecutive tests, Arch. Int. Med. 51: 903-919, 1933. CrossrefGoogle Scholar4. Schiff L: Gastric secretion in man: observations on the effects of repeated injections of histamine and on transient achlorhydria, Arch. Int. Med. 61: 774-780, 1938. CrossrefGoogle Scholar5. DietrichShelby HDC: Gastric analysis in childhood, Am. J. Dis. Child. 41: 1086-1099, 1931. Google Scholar6. Neale AV: Gastric secretion in infants and children, Arch. Dis. Childhood 5: 137-145, 1930. CrossrefMedlineGoogle Scholar7. Wright CB: Gastric secretion, gastro-intestinal motility and position of the stomach in a group of 250 children of Lymanhurst School, Arch. Int. Med. 33: 435-448, 1924. CrossrefGoogle Scholar8. DaviesJames DTTG: An investigation into the gastric secretion of a hundred normal persons over the age of sixty, Quart. J. Med. 23: 1-14, 1930. CrossrefGoogle Scholar9. Dedichen L: Anacidity in old persons, Acta med. Scandinav. (Suppl.) 7: 345-350, 1924. Google Scholar10. Seidelin H: Untersuchung des Mageninhaltes bei älteren Individuen, Berl. klin. Wchnschr. 41: 945-949, 1904. Google Scholar11. BloomfieldKeefer ALCS: Gastric acidity: relation to various factors such as age and physical fitness, J. Clin. Investigation 5: 285-294, 1928. CrossrefMedlineGoogle Scholar12. KeeferBloomfield CSAL: The significance of gastric anacidity, Bull. Johns Hopkins Hosp. 39: 304-329, 1926. Google Scholar13. von den Velden R: Ueber Vorkommen und Mangel der freien Salzsäure im Magensaft bei Gastrektasie, Deutsches Arch. f. klin. Med. 23: 369-399, 1879. Google Scholar14. Miehe W: Ueber die Salzsäure bei Magencarcinom, 1890, P. Scheiner, Würzburg, p. 44. Google Scholar15. Oppeler B: Zur Kenntnis des Mageninhalts beim Carcinoma ventriculi, Deutsche med. Wchnschr. 21: 73-75, 1895. CrossrefGoogle Scholar16. Ewald CA: The diseases of the stomach (translated by Morris Manges), Rev. Ed. 2, 1902, D. Appleton and Company, New York, 602 pp. Google Scholar17. Riegel F: Diseases of the stomach (translated by Alfred Stengel), 1903, W. B. Saunders Company, Philadelphia, 835 pp. Google Scholar18. Boas I: Diseases of the stomach (translated by Albert Bernheim), 1908, F. A. Davis Company, Philadelphia, 730 pp. Google Scholar19. Cohnheim P: Diseases of the digestive canal (oesophagus, stomach, intestines). (Translated by Dudley Fulton.) Ed. 2, 1911, J. B. Lippincott Company, Philadelphia, 383 pp. Google Scholar20. Einhorn M: Diseases of the stomach; a text-book for practitioners and students, Rev. Ed. 5, 1911, William Wood & Co., New York, 531 pp. Google Scholar21. SmithiesOchsner FAJ: Cancer of the stomach; a clinical study of 921 operatively and pathologically demonstrated cases, 1916, W. B. Saunders Company, Philadelphia, 522 pp. Google Scholar22. Osler W: The principles and practice of medicine, Ed. 8, 1919, D. Appleton and Company, New York, 1225 pp. Google Scholar23. Hartman HR: The prevalence of free hydrochloric acid in cases of carcinoma of the stomach, Am. J. M. Sc. 163: 186-190, 1922. CrossrefGoogle Scholar24. ComfortVanzant MWFR: Gastric acidity in carcinoma of the stomach, Tr. Am. Gastro-enterol. A. 1933, pp. 264-279; Proc. Staff Meet., Mayo Clin. 8: 271-272, 1933. Google Scholar25. ComfortVanzant MWFR: Gastric acidity in carcinoma of the stomach, Am. J. Surg. 26: 447-456, 1934. CrossrefGoogle Scholar26. Bueermann WH: A clinical and pathological study of the carcinomatous gastric ulcer; with particular references to the grading of malignancy, West. J. Surg. 38: 680-691; 768-777, 1930; 39: 37-43; 103-116; 217-219; 301-308, 1931. Google Scholar27. EustermanBueermann GBWH: Carcinoma of the stomach: present status of diagnosis and prognosis, J. A. M. A. 88: 295-301, 1927. CrossrefGoogle Scholar28. WaltersGrayPriestley WHKJT: Carcinoma and other malignant lesions of the stomach, 1942, W. B. Saunders Company, Philadelphia, 576 pp. Google Scholar29. ComfortButschEusterman MWWLGB: Observations on gastric acidity before and after development of carcinoma of the stomach, Am. J. Digest. Dis. 4: 673-681, 1937. CrossrefGoogle Scholar30. ComfortKelseyBerkson MWMPJ: Gastric acidity before and after the development of carcinoma of the stomach, J. Nat. Cancer Inst. 7: 367-373, 1947. MedlineGoogle Scholar31. Stewart A: Gastric acidity in infants and young children under normal and pathological conditions with special reference to nutritional anaemia, Brit. J. Child. Dis. 34: 1-27, 1937. Google Scholar32. Olson SW: The gastric mucosa in pernicious anemia; a study of 94 autopsy cases from the Department of Pathologic Anatomy of the Mayo Clinic. Thesis, Graduate School, University of Minnesota, 1943, 77 pp. Google Scholar33. Faber KH: Gastritis and its consequences, 1935, Oxford University Press, London, 119 pp. Google Scholar34. GuissStewart LWFW: Chronic atrophic gastritis and cancer of the stomach, Arch. Surg. 46: 823-843, 1943. CrossrefGoogle Scholar35. Judd ES: Residual lesions of ulcerative gastritis; possible relationship to the development of carcinoma of the stomach, Surg., Gynec. and Obst. 75: 424-432, 1942. Google Scholar36. Orator V: Beiträge zur Magenpathologie. II. Zur Pathologie und Genese des Carcinoms und Ulcuscarcinoms des Magens, Virchows Arch. f. path. Anat. 256: 202-229, 1925. CrossrefGoogle Scholar37. Schindler R: Gastritis, 1947, Grune and Stratton, New York, 462 pp. Google Scholar38. Stout AP: Gastric mucosal atrophy and carcinoma of the stomach, New York State J. Med. 45: 973-977, 1945. Google Scholar39. WarrenMeissner SWA: Chronic gastritis and carcinoma of the stomach, Gastroenterology 3: 251-256, 1944. Google Scholar40. Hebbel R: Chronic gastritis: its relation to gastric and duodenal ulcer and to gastric carcinoma, Am. J. Path. 19: 43-71, 1943. MedlineGoogle Scholar41. VanzantAlvarezBerksonEusterman FRWCJGB: Changes in gastric acidity in peptic ulcer, cholecystitis and other diseases: analyzed with the help of a new and accurate technic, Arch. Int. Med. 52: 616-631, 1933. CrossrefGoogle Scholar42. Hebbel R: The topography of chronic gastritis in otherwise normal stomachs, Am. J. Path. 25: 125-141, 1949. MedlineGoogle Scholar43. Baker CP: Quoted by Comfort, M. W., Butsch, W. L., and Eusterman, G. B.29 Google Scholar44. BrunschwigClarkeVan ProhaskaSchmitz ATHJRL: A secretory depressant in the achlorhydric gastric juice of patients with carcinoma of the stomach, Surg., Gynec. and Obst. 70: 25-30, 1940. Google Scholar45. BrunschwigClarkeVan ProhaskaSchmitz ATHJRL: A gastric secretory depressant in extracts of achlorhydric carcinomatous stomachs, Ann. Surg. 113: 41-46, 1941. CrossrefMedlineGoogle Scholar46. BrunschwigRasmussenCampMoe ARAEJR: Gastric secretory depressant in gastric juice, Surgery 12: 887-891, 1942. Google Scholar47. BrunschwigSchmitzRasmussen ARLR: Experimental observations on achlorhydria of gastric cancer, J. Nat. Cancer Inst. 1: 481-487, 1941. Google Scholar48. BrunschwigVan ProhaskaClarkeKandel AJTHE: A secretory depressant in gastric juice of patients with pernicious anemia, J. Clin. Investigation 18: 415-422, 1939. CrossrefMedlineGoogle Scholar49. BockusBankWillard HLJJH: Achlorhydria with a review of 210 cases in patients with gastrointestinal complaints, Am. J. M. Sc. 184: 185-201, 1932. CrossrefGoogle Scholar50. Robertson JD: Development of achlorhydria and pyloric stenosis in cases of carcinoma of the stomach, Lancet 1: 1495-1497, 1935. Google Scholar51. ShaySchloss HEM: A consideration of the gastric ulcer-cancer problem; with the report of a case of ulcerating carcinoma in which the gastric acidity changed from normal to anacidity while under observation, Ann. Int. Med. 7: 1218-1229, 1934. LinkGoogle Scholar52. CowgillGilman GRA: Physiology of vitamins. XXIII. The effect of lack of the vitamin B complex on the secretion of gastric juice in dogs with gastric pouches, Arch. Int. Med. 53: 58-70, 1934. CrossrefGoogle Scholar53. Odin M: Certain kinds of diet in connection with diseases among various groups of population in various parts of Sweden, Acta med. Scandinav. (Suppl.) 59-62: 10-34, 1934. Google Scholar54. WebsterArmour DRJC: Effect of vitamin deficiency on gastric secretion, Proc. Soc. Exper. Biol. and Med. 30: 1297-1300, 1933. CrossrefGoogle Scholar55. CromerComfortButtBerkson HEMWHRJ: Gastric acidity in cases of adenomatous gastric polyp. Unpublished data. Google Scholar56. DoehringEusterman PCGB: Association of pernicious anemia and carcinoma of the stomach, Arch. Surg. 45: 554-563, 1942. CrossrefGoogle Scholar57. KaplanRigler HSLG: Pernicious anemia and carcinoma of the stomach: autopsy studies concerning their interrelationship, Am. J. M. Sc. 209: 339-348, 1945. CrossrefGoogle Scholar58. RiglerKaplan LGHS: Pernicious anemia and tumors of the stomach, J. Nat. Cancer Inst. 7: 327-332, 1947. MedlineGoogle Scholar59. Ivy AC: Discussion, J. Nat. Cancer Inst. 7: 404-407, 1947. Google Scholar60. BloomfieldPolland ALWS: The diagnostic value of studies of gastric secretion, J. A. M. A. 92: 1508-1513, 1929. CrossrefGoogle Scholar61. ComfortButsch MWWL: Differential diagnosis of benign and malignant small lesions of stomach; an attempt to evaluate statistically the various symptoms and laboratory findings, Am. J. Surg. 35: 515-523, 1937. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Rochester, Minnesota*Read at the meeting of the American Medical Association, Atlantic City, New Jersey, June 6 to 10, 1949. Received for publication December 9, 1949.From the Division of Medicine of the Mayo Clinic, Rochester, Minnesota. 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