Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Journal of Gastrointestinal Cancer
Erschienen in: Journal of Gastrointestinal Cancer 2/2014

01.06.2014 | Review Article

H. pylori Infection, Inflammation and Gastric Cancer

verfasst von: Qurteeba Qadri, Roohi Rasool, G. M. Gulzar, Sameer Naqash, Zafar A. Shah

Erschienen in: Journal of Gastrointestinal Cancer | Ausgabe 2/2014

Einloggen, um Zugang zu erhalten

Abstract

Introduction

A strong association between chronic infection, inflammation, and cancer has been suggested.

Discussion

Helicobacter pylori, a microaerophilic gram negative bacterium, infects about half the world’s population. It has been defined as a definitive carcinogen in the pathogenesis of gastric cancer. H. pylori evades the host immune responses and persists in the stomach leading to gastritis gastric atrophy and sometimes gastric cancer.

Conclusion

Chronic H. pylori infection causes gastric cancer via two mechanisms: the presence of virulence factors and the induction of chronic inflammation which ultimately leads to neoplastic transformation.
Literatur
1.
2.
Shacter E, Weitzman SA. Chronic inflammation and cancer. Oncology. 2002;16:217–26.PubMed
3.
Hussain SP, Hofseth LJ, Harris CC. Radical causes of cancer. Nat Rev Cancer. 2003;3:276–85.PubMedCrossRef
4.
Zarrilli R, Ricci V, Romano M. Molecular response of gastric epithelial cells to Helicobacter pylori-induced cell damage. Cell Microbiol. 1999;1:93–9.PubMedCrossRef
5.
Hessey SJ, Spencer J, Wyatt JI, Sobala G, Rathbone BJ, Axon AT, et al. Bacterial adhesion and disease activity in Helicobacter associated chronic gastritis. Gut. 1990;31:134–8.PubMedCentralPubMedCrossRef
6.
Solnick JV, Hansen LM, Salama NR, Boonjakuakul JK, Syvanen M. Modification of Helicobacter pylori outer membrane protein expression during experimental infection of rhesus macaques. Proc Natl Acad Sci U S A. 2004;101:2106–11.PubMedCentralPubMedCrossRef
7.
Franco AT, Johnston E, Krishna U, Yamaoka Y, Israel DA, Nagy TA, et al. Regulation of gastric carcinogenesis by Helicobacter pylori virulence factors. Cancer Res. 2008;68:379–87.PubMedCentralPubMedCrossRef
8.
Segal ED, Lange C, Covacci A, Tompkins LS, Falkow S. Induction of host signal transduction pathways by Helicobacter pylori. Proc Natl Acad Sci U S A. 1997;94:7595–9.PubMedCentralPubMedCrossRef
9.
Suerbaum S. Genetic variability within Helicobacter pylori. Int J Med Microbiol. 2000;290:175–81.PubMedCrossRef
10.
Weeks DL, Eskandari S, Scott DR, Sachs GA. H+-gated urea channel: the link between Helicobacter pylori urease and gastric colonization. Science. 2000;287:482–5.PubMedCrossRef
11.
Perez-Perez GI, Shepherd VL, Morrow JD, Blaser MJ. Activation of human THP-1 cells and rat bone marrow-derived macrophages by Helicobacter pylori lipopolysaccharide. Infect Immun. 1995;63:1183–7.PubMedCentralPubMed
12.
Reeves EP, Ali T, Leonard P, Hearty S, O’Kennedy R, May FE, et al. Helicobacter pylori lipopolysaccharide interacts with TFF1 in a pH-dependent manner. Gastroenterology. 2008;135:2043–54.PubMedCrossRef
13.
Axsen WS, Styer CM, Solnick JV. Inhibition of heat shock protein expression by Helicobacter pylori. Microb Pathog. 2009;47:231–6.PubMedCrossRef
14.
Alm RA, Ling LS, Moir DT, King BL, Brown ED, Doig PC, et al. Genomic-sequence comparison of two unrelated isolates of the human gastric pathogen Helicobacter pylori. Nature. 1999;397:176–80.PubMedCrossRef
15.
Naito Y, Yoshikawa T. Molecular and cellular mechanisms involved in Helicobacter pylori-induced inflammation and oxidative stress. Free Radic Biol Med. 2002;33:323–36.PubMedCrossRef
16.
Hatakeyama M. Helicobacter pylori CagA—a bacterial intruder conspiring gastric carcinogenesis. Int J Cancer. 2006;119:1217–23.PubMedCrossRef
17.
Higashi H, Tsutsumi R, Fujita A, Yamazaki S, Asaka M, Azuma T, et al. Biological activity of the Helicobacter pylori virulence factor CagA is determined by variation in the tyrosine phosphorylation sites. Proc Natl Acad Sci U S A. 2002;99:14428–33.PubMedCentralPubMedCrossRef
18.
Azuma TA, Yamakawa S, Yamazaki K, Fukuta M, Ohtani Y, Ito M, et al. Correlation between variation of the 3_ region of the cagA gene in Helicobacter pylori and disease outcome in Japan. J Infect Dis. 2002;186:1621–30.PubMedCrossRef
19.
Keates S, Keates AC, Warny M, Peek Jr RM, Murray PG, Kelly CP. Differential activation of mitogen-activated protein kinases in AGS gastric epithelial cells by cag+ and cag− Helicobacter pylori. J Immunol. 1999;163:5552–9.PubMed
20.
Higashi H, Tsutsumi R, Muto S, Sugiyama T, Azuma T, Asaka M, et al. SHP-2 tyrosine phosphatase as an intracellular target of Helicobacter pylori CagA protein. Science. 2002;295:683–6.PubMedCrossRef
21.
De Souza D, Fabri LJ, Nash A, Hilton DJ, Nicola NA, Baca M. SH2 domains from suppressor of cytokine signaling-3 and protein tyrosine phosphatase SHP-2 have similar binding specificities. Biochemistry. 2002;41:9229–36.PubMedCrossRef
22.
Tsutsumi R, Higashi H, Higuchi M, Okada M, Hatakeyama M. Attenuation of Helicobacter pylori CagA SHP-2 signaling by interaction between CagA and C-terminal Src kinase. J Biol Chem. 2003;278:3664–70.PubMedCrossRef
23.
Backert S, Moese S, Selbach M, Brinkmann V, Meyer TF. Phosphorylation of tyrosine 972 of the Helicobacter pylori CagA protein is essential for induction of a scattering phenotype in gastric epithelial cells. Mol Microbiol. 2001;42:631–44.PubMedCrossRef
24.
Neel BG, Gu H, Pao L. The ‘Shp’ing news: SH2 domain-containing tyrosine phosphatases in cell signaling. Trends Biochem Sci. 2003;28:284–93.PubMedCrossRef
25.
Suerbaum S, Josenhans C, Claus H, Frosch M. Bacterial genomics: seven years on. Trends Microbiol. 2002;10:351–3.PubMedCrossRef
26.
Stein M, Rappuoli R, Covacci A. Tyrosine phosphorylation of the Helicobacter pylori CagA antigen after cag-driven host cell translocation. Proc Natl Acad Sci U S A. 2000;97:1263–8.PubMedCentralPubMedCrossRef
27.
Moese S, Selbach M, Brinkmann V, Karlas A, Haimovich B, Backert S, et al. The Helicobacter pylori CagA protein disrupts matrix adhesion of gastric epithelial cells by dephosphorylation of vinculin. Cell Microbiol. 2007;9:1148–61.PubMedCrossRef
28.
Selbach M, Moese S, Backert S, Jungblut PR, Meyer TF. The Helicobacter pylori CagA protein induces tyrosine dephosphorylation of ezrin. Proteomics. 2004;4:2961–8.PubMedCrossRef
29.
Churin Y, Al-Ghoul L, Kepp O, Meyer TF, Birchmeier W, Naumann M. Helicobacter pylori CagA protein targets the c-Met receptor and enhances the motogenic response. J Cell Biol. 2003;161:249–55.PubMedCentralPubMedCrossRef
30.
Mimuro H, Suzuki T, Tanaka J, Asahi M, Haas R, Sasakawa C. Grb2 is a key mediator of Helicobacter pylori CagA protein activities. Mol Cell. 2002;10:745–55.PubMedCrossRef
31.
Cheng AM, Saxton TM, Sakai R, Kulkarni S, Mbamalu G, Vogel W, et al. Mammalian Grb2 regulates multiple steps in embryonic development and malignant transformation. Cell. 1998;95:793–803.PubMedCrossRef
32.
Fodde R, Brabletz T. Wnt/b-catenin signaling in cancer stemness and malignant behavior. Curr Opin Cell Biol. 2007;19:150–8.PubMedCrossRef
33.
34.
Brandt S, Kwok T, Hartig R, König W, Backert S. NFkB activation and potentiation of proinflammatory responses by the Helicobacter pylori CagA protein. Proc Natl Acad Sci U S A. 2005;102:9300–5.PubMedCentralPubMedCrossRef
35.
Peek Jr RM, Vaezi MF, Falk GW, Goldblum JR, Perez-Perez GI, Richter JE, et al. Role of Helicobacter pylori cagA(+) strains and specific host immune responses on the development of premalignant and malignant lesions in the gastric cardia. Int J Cancer. 1999;82:520–4.PubMedCrossRef
36.
Kuck D, Kolmerer B, Iking-Konert C, Krammer PH, Stremmel W, Rudi J. Vacuolating cytotoxin of Helicobacter pylori induces apoptosis in the human gastric epithelial cell line AGS. Infect Immun. 2001;69:5080–7.PubMedCentralPubMedCrossRef
37.
Peek Jr RM. Helicobacter pylori strain-specific modulation of gastric mucosal cellular turnover: implications for carcinogenesis. J Gastroenterol. 2002;37 Suppl 13:10–6.PubMedCrossRef
38.
Atherton JC, Cao P, Peek M, Tummuru MK, Blaser MJ, Cover TL. Mosaicism in vacuolating cytotoxin alleles of Helicobacter pylori: association of specific vacA types with cytotoxin production and peptic ulceration. J Biol Chem. 1995;270:17771–7.PubMedCrossRef
39.
Figueiredo C, Van Doorn LJ, Nogueira C, Soares JM, Pinho C, Figueira P, et al. Helicobacter pylori genotypes are associated with clinical outcome in Portuguese patients and show a high prevalence of infections with multiple strains. Scand J Gastroenterol. 2001;36:128–35.PubMedCrossRef
40.
Rhead JL, Letley DP, Mohammadi M, Hussein N, Mohagheghi MA, Eshagh Hosseini M, et al. A new Helicobacter pylori vacuolating cytotoxin determinant, the intermediate region, is associated with gastric cancer. Gastroenterology. 2007;133:926–36.PubMedCrossRef
41.
Torres VJ, VanCompernolle SE, Sundrud MS, Unutmaz D, Cover TL. Helicobacter pylori vacuolating cytotoxin inhibits activation-induced proliferation of human T and B lymphocyte subsets. J Immunol. 2007;179(8):5433–40.PubMedCrossRef
42.
Menaker RJ, Ceponis PJM, Jones NL. Helicobacter pylori induces apoptosis of macrophages in association with alterations in the mitochondrial pathway. Infect Immun. 2004;72(5):2889–98.PubMedCentralPubMedCrossRef
43.
Zheng PY, Jones NL. Helicobacter pylori strains expressing the vacuolating cytotoxin interrupt phagosome maturation in macrophages by recruiting and retaining TACO (coronin 1) protein. Cell Microbiol. 2003;5(1):25–40.PubMedCrossRef
44.
Schmees C, Prinz C, Treptau T, et al. Inhibition of T-cell proliferation by Helicobacter pylori gamma-glutamyl transpeptidase. Gastroenterology. 2007;132(5):1820–33.PubMedCrossRef
45.
Zabaleta J, McGee DJ, Zea AH, et al. Helicobacter pylori arginase inhibits T cell proliferation and reduces the expression of the TCR zeta-chain (CD3zeta). J Immunol. 2004;173(1):586–93.PubMedCrossRef
46.
Gobert P, McGee DJ, Akhtar M, et al. Helicobacter pylori arginase inhibits nitric oxide production by eukaryotic cells: a strategy for bacterial survival. Proc Natl Acad Sci U S A. 2001;98(24):13844–9.PubMedCentralPubMedCrossRef
47.
Yuan J, Li P, Tao J, et al. H. pylori escape host immunoreactions through inhibiting ILK expression by VacA. Cell Mol Immunol. 2009;6(3):191–7.PubMedCrossRef
48.
Everhart JE. Recent developments in the epidemiology of Helicobacter pylori. Gastroenterol Clin North Am. 2000;29:559–78.PubMedCrossRef
49.
Peek Jr RM, Blaser MJ. Helicobacter pylori and gastrointestinal tract adenocarcinomas. Nat Rev Cancer. 2002;2:28–37.PubMedCrossRef
50.
El-Omar EM, Rabkin CS, Gammon MD, Vaughan TL, Risch HA, Schoenberg JB, et al. Increased risk of noncardia gastric cancer associated with proinflammatory cytokine gene polymorphisms. Gastroenterology. 2003;124:1193–201.PubMedCrossRef
51.
Hansson LE, Nyren O, Hsing AW, Bergstrom R, Josefsson S, Chow WH, et al. The risk of stomach cancer in patients with gastric or duodenal ulcer disease. N Engl J Med. 1996;335:242–9.PubMedCrossRef
52.
Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784–9.PubMedCrossRef
53.
Mannick EE, Bravo LE, Zarama G, Realpe JL, Zhang XJ, Ruiz B, et al. Inducible nitric oxide synthase, nitrotyrosine, and apoptosis in Helicobacter pylori gastritis: effect of antibiotics and antioxidants. Cancer Res. 1996;56:3238–43.PubMed
54.
Jaiswal M, LaRusso NF, Gores GJ. Nitric oxide in gastrointestinal epithelial cell carcinogenesis: linking inflammation to oncogenesis. Am J Physiol Gastrointest Liver Physiol. 2001;281:G626–34.PubMed
55.
Salvemini D, Misko TP, Masferrer JL, Seibert K, Currie MG, Needleman P. Nitric oxide activates cyclooxygenase enzymes. Proc Natl Acad Sci U S A. 1993;90:7240–4.PubMedCentralPubMedCrossRef
56.
Sung JJ, Leung WK, Go MY, To KF, Cheng AS, Ng EK, et al. Cyclooxygenase-2 expression in Helicobacter pylori-associated premalignant and malignant gastric lesions. Am J Pathol. 2000;157:729–35.PubMedCentralPubMedCrossRef
57.
Dubois RN, Abramson SB, Crofford L, Gupta RA, Simon LS, Van De Putte LB, et al. Cyclooxygenase in biology and disease. FASEB J. 1998;12:1063–73.PubMed
58.
Sharma SA, Tummuru MK, Blaser MJ, Kerr LD. Activation of IL-8 gene expression by Helicobacter pylori is regulated by transcription factor nuclear factor-kappa B in gastric epithelial cells. J Immunol. 1998;160:2401–7.PubMed
59.
Hatz RA, Rieder G, Stolte M, Bayerdorffer E, Meimarakis G, Schildberg FW, et al. Pattern of adhesion molecule expression on vascular endothelium in Helicobacter pylori associated antral gastritis. Gastroenterology. 1997;112:1908–19.PubMedCrossRef
60.
Mazzucchelli L, Blaser A, Kappeler A, et al. BCA-1 is highly expressed in Helicobacter pylori-induced mucosa-associated lymphoid tissue and gastric lymphoma. J Clin Invest. 1999;104:R49–54.PubMedCentralPubMedCrossRef
61.
Medzhitov R, Preston-Hurlburt P, Janeway Jr CA. A human homologue of the Drosophila Toll protein signals activation of adaptive immunity. Nature. 1997;388:394–7.PubMedCrossRef
62.
Kawai T, Takeuchi O, Fujita T, Inoue J, Muhlradt PF, Sato S, et al. Lipopolysaccharide stimulates the MyD88-independent pathway and results in activation of IFN-regulatory factor 3 and the expression of a subset of lipopolysaccharide-inducible genes. J Immunol. 2001;167:5887–94.PubMedCrossRef
63.
Gasperini S, Marchi M, Calzetti F, Laudanna C, Vicentini L, Olsen H, et al. Gene expression and production of the monokine induced by IFN-gamma (MIG), IFN-inducible T cell alpha chemoattractant (ITAC), and IFN-gamma-inducible protein-10 (IP-10) chemokines by human neutrophils. J Immunol. 1999;162:4928–37.PubMed
64.
65.
66.
Benelli R, Morini M, Carrozzino F, Ferrari N, Minghelli S, Santi L, et al. Neutrophils as a key cellular target for angiostatin: implications for regulation of angiogenesis and infl ammation. FASEB J. 2002;16:267–9.PubMed
67.
Renshaw M, Rockwell J, Engleman C, Gewirtz A, Katz J, Sambhara S. Cutting edge: impaired Toll-like receptor expression and function in aging. J Immunol. 2002;169:4697–701.PubMedCrossRef
68.
Petersson C, Forsberg M, Aspholm M, et al. Helicobacter pylori SabA adhesin evokes a strong inflammatory response in human neutrophils which is down-regulated by the neutrophil-activating protein. Med Microbiol Immunol. 2006;195(4):195–206.PubMedCrossRef
69.
Battan M, Raviglione C, Palagiano A, et al. Helicobacter pylori infection in patients with acquired immune deficiency syndrome. Am J Gastroenterol. 1990;85(12):1576–9.PubMed
70.
Wunder C, Churin Y, Winau F. Cholesterol glucosylation promotes immune evasion by Helicobacter pylori. Nat Med. 2006;12(9):1030–8.PubMedCrossRef
71.
Ringnér M, Valkonen RK, Wadström T. Binding of vitronectin and plasminogen to Helicobacter pylori. FEMS Immunol Med Microbiol. 1994;9(1):29–34.PubMed
72.
Andersen-Nissen E, Smith KD, Strobe KL, et al. Evasion of Toll-like receptor 5 by flagellated bacteria. Proc Natl Acad Sci U S A. 2005;102(26):9247–52.PubMedCentralPubMedCrossRef
73.
Gewirtz T, Yu Y, Krishna US, Israel DA, Lyons SL, Peek RM. Helicobacter pylori flagellin evades toll-like receptor 5-mediated innate immunity. J Infect Dis. 2004;189(10):1914–20.PubMedCrossRef
74.
Lee SK, Stack A, Katzowitsch E, Aizawa SI, Suerbaum S, Josenhans C. Helicobacter pylori flagellins have very low intrinsic activity to stimulate human gastric epithelial cells via TLR5. Microbes Infect. 2003;5(15):1345–56.PubMedCrossRef
75.
Karin M et al. NF-kappaB: linking inflammation and immunity to cancer development and progression. Nat Rev Immunol. 2005;5:749–59.PubMedCrossRef
76.
77.
Westbrook AM et al. Mechanisms of intestinal inflammation and development of associated cancers: lessons learned from mouse models. Mutat Res. 2010;705:40–59.PubMedCentralPubMedCrossRef
78.
79.
80.
Popivanova BK et al. Blocking TNF-alpha in mice reduces colorectal carcinogenesis associated with chronic colitis. J Clin Invest. 2008;118:560–70.PubMedCentralPubMed
81.
Kim YJ et al. Prevention of colitis-associated carcinogenesis with infliximab. Cancer Prev Res (Phila). 2010;3:1314–33.CrossRef
82.
Correa P. Chronic gastritis: a clinico-pathological classification. Am J Gastroenterol. 1988;83(5):504–9.PubMed
83.
Correa P, Cuello C, Duque E, et al. Gastric cancer in Colombia. III. Natural history of precursor lesions. J Natl Cancer Inst. 1976;57(5):1027–35.PubMed
84.
Cuello C, Correa P, Haenszel W, et al. Gastric cancer in Colombia. I. Cancer risk and suspect environmental agents. J Natl Cancer Inst. 1976;57(5):1015–20.PubMed
85.
Haenszel W, Correa P, Cuello C, et al. Gastric cancer in Colombia. II. Case control epidemiologic study of precursor lesions. J Natl Cancer Inst. 1976;57(5):1021–6.PubMed
86.
Correa P, Haenszel W, Cuello C, et al. Gastric precancerous process in a high risk population: cohort follow-up. Cancer Res. 1990;50(15):4737–40.PubMed
87.
88.
Delahay RM, Rugge M. Pathogenesis of Helicobacter pylori infection. Helicobacter. 2012;17(1):9–15.PubMed
89.
Gonzalo Carrasco and Alejandro H. Corvalan. Helicobacter pylori-Induced Chronic Gastritis and Assessing Risks for Gastric Cancer. Gastroenterology Res Pract Vol 2013, Article ID 393015, 8 pages doi:10.​1155/​2013/​393015.
Metadaten
Titel
H. pylori Infection, Inflammation and Gastric Cancer
verfasst von
Qurteeba Qadri
Roohi Rasool
G. M. Gulzar
Sameer Naqash
Zafar A. Shah
Publikationsdatum
01.06.2014
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Cancer / Ausgabe 2/2014
Print ISSN: 1941-6628
Elektronische ISSN: 1941-6636
DOI
https://doi.org/10.1007/s12029-014-9583-1

Weitere Artikel der Ausgabe 2/2014

Journal of Gastrointestinal Cancer 2/2014 Zur Ausgabe

Case Report

Colonic Intussusception Induced by Massive Tubular Adenoma in a Patient Post-Radiofrequency Ablation

Original Research

Assessment of the Value of MRI Scan in Addition to CT in the Pre-operative Staging of Colorectal Liver Metastases

Case Report

Cholangiocarcinoma Presenting as Sister Mary Joseph’s Nodule: Case Report and Short Review of the Literature

Editorial

Are We Denying Distant Control? A Call for Revising the Treatment Protocols of Patients with Ultra-Low Rectal Cancer Who Potentially Require Abdominoperineal Resection

Case Report

Primary Multifocal Malignant Melanoma of the Esophagus

Original Research

Prognosis Impact of the Lymph Node Ratio in Patients with Colon Adenocarcinoma: a Single-Centre Experience

Neu im Fachgebiet Onkologie

Erhöhte Mortalität bei postpartalem Brustkrebs

07.05.2024 Mammakarzinom Nachrichten

Auch für Trägerinnen von BRCA-Varianten gilt: Erkranken sie fünf bis zehn Jahre nach der letzten Schwangerschaft an Brustkrebs, ist das Sterberisiko besonders hoch.

Hypertherme Chemotherapie bietet Chance auf Blasenerhalt

07.05.2024 Harnblasenkarzinom Nachrichten

Eine hypertherme intravesikale Chemotherapie mit Mitomycin kann für Patienten mit hochriskantem nicht muskelinvasivem Blasenkrebs eine Alternative zur radikalen Zystektomie darstellen. Kölner Urologen berichten über ihre Erfahrungen.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Bessere Prognose mit links- statt rechtsseitigem Kolon-Ca.

06.05.2024 Kolonkarzinom Nachrichten

Menschen mit linksseitigem Kolonkarzinom leben im Mittel zweieinhalb Jahre länger als solche mit rechtsseitigem Tumor. Auch aktuell ist das Sterberisiko bei linksseitigen Tumoren US-Daten zufolge etwa um 11% geringer als bei rechtsseitigen.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise