Linitis plastica primary prevention
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An effective measure for the primary prevention of hereditary diffuse gastric adenocarcinoma includes prophylactic gastrectomy in individuals who test positive for CDH1 gene mutations.Genetic testing can be carried out in those who have family history of hereditary diffuse gastric adenocarcinoma. The risk for developing gastric cancer is high enough to warrant prophylactic gastrectomy in these patients.
- CDH1 mutation is detected in 15 - 50 percent of those with hereditary diffuse gastric adenocarcinoma.
- The risk of developing diffuse gastric adenocarcinoma in an individual with CDH1 mutation is 70 percent in men and up to 56 percent in women.
- In 2015, the IGCLC (International Gastric Cancer Linkage Consortium) established criteria for CDH1 mutation testing. A blood or saliva sample is analyzed. Individuals who fall into any of these criteria are candidates for genetic testing:
- Two cases of gastric cancer in a family regardless of their age, one of which must have a confirmed case of diffuse gastric cancer.
- Any individual under the age of 40 with diffuse gastric cancer.
- Any individual with a personal or family history of first or second degree relative with of diffuse gastric cancer and lobular breast cancer, one of which was diagnosed under the age of 50.
- Two or more cases of lobular breast carcinoma less than 50 years of age with bilateral lobular breast carcinoma or a family history in a first of second degree relative.
- A history of a cleft lip and/or palate or a family history of cleft lip and/or palate in a first or second degree relative with diffuse gastric carcinoma.
- A gastric biopsy that shows evidence of in situ signet ring cells and/or paget-configured spread of signet ring cells.
- Pandalai PK, Lauwers GY, Chung DC, Patel D, Yoon SS (2011). "Prophylactic total gastrectomy for individuals with germline CDH1 mutation". Surgery. 149 (3): 347–55. doi:10.1016/j.surg.2010.07.005. PMID 20719348.
- Chun YS, Lindor NM, Smyrk TC, Petersen BT, Burgart LJ, Guilford PJ, Donohue JH (2001). "Germline E-cadherin gene mutations: is prophylactic total gastrectomy indicated?". Cancer. 92 (1): 181–7. PMID 11443625.
- Norton JA, Ham CM, Van Dam J, Jeffrey RB, Longacre TA, Huntsman DG, Chun N, Kurian AW, Ford JM (2007). "CDH1 truncating mutations in the E-cadherin gene: an indication for total gastrectomy to treat hereditary diffuse gastric cancer". Ann. Surg. 245 (6): 873–9. doi:10.1097/01.sla.0000254370.29893.e4. PMC 1876967. PMID 17522512.
- van der Post RS, Vogelaar IP, Carneiro F, Guilford P, Huntsman D, Hoogerbrugge N, Caldas C, Schreiber KE, Hardwick RH, Ausems MG, Bardram L, Benusiglio PR, Bisseling TM, Blair V, Bleiker E, Boussioutas A, Cats A, Coit D, DeGregorio L, Figueiredo J, Ford JM, Heijkoop E, Hermens R, Humar B, Kaurah P, Keller G, Lai J, Ligtenberg MJ, O'Donovan M, Oliveira C, Pinheiro H, Ragunath K, Rasenberg E, Richardson S, Roviello F, Schackert H, Seruca R, Taylor A, Ter Huurne A, Tischkowitz M, Joe ST, van Dijck B, van Grieken NC, van Hillegersberg R, van Sandick JW, Vehof R, van Krieken JH, Fitzgerald RC (2015). "Hereditary diffuse gastric cancer: updated clinical guidelines with an emphasis on germline CDH1 mutation carriers". J. Med. Genet. 52 (6): 361–74. doi:10.1136/jmedgenet-2015-103094. PMC 4453626. PMID 25979631.