INTESTINAL TYPE UPPER GI ADENOCARCINOMA DEVELOPS EARLIER IN SCOTTISH MALES

Chronic mucosal damage resulting from either reflux in the oesophagus or H pylori infection in the stomach leads to intestinal type adenocarcinoma with a strong male predominance, greatest in the oesophagus and least in the antrum. Since subtype varies by site it is unclear which of these variables is the strongest predictor of male predominance. The current study addressed this question using the West of Scotland Cancer Registry covering 3 million people. Histology was reviewed in 812 randomly selected cases and the subtype determined using the Lauren classification. Overall 63.8% of cancer patients were male, 55.1% non-cardiac stomach, 22% gastric cardia and 26.6% oesophageal. The male predominance was greatest in the oesophagus, the male/female ratio being 3.5, 2.0 in the cardia and 1.65 for non-cardiac gastric cancers. Multivariate analysis showed that the gender effect was lost when age and subtype were included. As the figure shows, the male predominance is largely due to males developing the intestinal subtype 17 years earlier than females, while the diffuse subtype showed no gender bias. The authors speculate that oestrogen may delay carcinogenesis by suppressing the inflammatory response.

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ABNORMAL SMALL INTESTINAL BARRIER FUNCTION IS NECESSARY FOR COLITIS TO OCCUR IN IL10^–/– MICE

Increased intestinal permeability has been found to be associated with inflammatory bowel disease, but whether it is aetiologically important is a matter of debate. Interleukin 10 gene deficient (IL10 …