Endoscopic diagnosis of postoperative stomach cancer]

The authors examined endoscopically the esophagus and stomach in 309 patients, previously operated upon for gastric cancer (258), ulcer of the stomach or duodenum (36) and benign gastric tumors (15). They estimated the value of this method for establishing diagnosis of the operated stomach cancer and also the importance of histological and cytological methods in the complex diagnosis of this pathology. Moreover, roentgeno-endoscopic correlations were made. Cancer of the operated stomach was detected in 59 patients, it was suspected in 8, other lesions were found in 194. no changes in the operated stomach were found in 48. It is stated that endoscopy is more advantageous than roentgenological examination in establishing the diagnosis of tumor pathology of the operated stomach. Histological and cytological findings are of considerable value in making the correct diagnosis. These methods are mostly informative in an exophytic form of the tumor growth.     

Improvement of ultrasonographic diagnosis of stomach cancer]

A method for abdominal ultrasonographic diagnosis of gastric cancer is suggested which includes evaluation of the gastric wall and regional lymph nodes, and search for distant metastases. Gastric tumors were visualized in 92.9% of cases. The procedure should be performed both in cancer suspects and cases with reliably established gastric neoplasm to assess local extent of tumor and detect regional and distant metastases.     

Supraclavicular metastases of stomach cancer

To precisely determine the process spread in gastric cancer, in 90 patients left prescalene biopsy was performed simultaneously with the operative procedure on the stomach. In 20% of the patients the histological examination of serial sections showed gastric cancer metastases in non-enlarged supraclavicular lymph nodes. In vast majority of the observations a supraclavicular metastasis diagnosed only histologically was a manifestation of the tumor process spread. In these patients only explorative laparotomy or palliative resection was performed, followed by lethal issue (but one case) in the early postoperative period. The rationale of incuding prescalene biopsy in the scheme of examination for gastric cancer is discussed.     

Use of large-frame fluorography in the diagnosis of stomach cancer]

A comparison of the results of non-aimed large-frame fluorography (LFF) and roentgen study of the stomach in 301 patients enabled ascertaining more precisely the opportunities of LFF in diagnosing gastric cancer. It was found by checking (fibrogastroscopy with biopsy or surger) that irrespective of the technic of non-aimed LFF, despite the diagnosis being known previously, cancer of the stomach still far from being in early stage may be recognized only in 62-63%. Therefore use of non-aimed LFF to diagnose gastric cancer during mass prophylactic examinations seems to be not rational.     

Salivary lysozyme in the screening for stomach cancer]

The study was concerned with measurement of lysozyme activity of saliva in healthy subjects and patients with different pathologies of the stomach including precancer and cancer. It established a considerable decrease in this parameter in cancer and precancer as compared with healthy controls. Assay of saliva lysozyme activity was found to yield more specific and prognostic data than clinical symptoms and examination of the patient. This procedure proved highly valuable in forming groups at risk for stomach cancer, due to providing significant differences in saliva lysozyme activity indices between "healthy subjects--stomach pathology" and "precancer--precancerous changes--stomach cancer" groups.     

Intraoperative diagnosis of incipient stomach cancer

A combination procedure of surgical fibrogastroscopy was employed for diagnosis of incipient gastric carcinoma. It involved a routine examination of the mucosa, transillumination (examination in transmitted light) and endoscopy of the illuminated surgically-exposed stomach, with the endoscope's ligh being switched off. The study conducted in 24 patients with incipient carcinoma showed the effectiveness of the said diagnostic procedure in identifying foci of such lesions, their anatomic pattern as well as the extent of involvement of different layers of the stomach wall, submucosal and serous muscular layer.     

Heterotopic ossification in the skeletal muscle metastases of advanced stomach cancer

The formation of heterotopic bone tissue in carcinomas of the gastrointestinal tract and/or their metastases is extremely rare. In a 74-year-old female with gastric adenocarcinoma, we observed extensive bone formation within metastases in the skeletal muscles. There are only 7 other cases of heterotopic bone formation in gastric cancer reported in the world literature. We suggest that heterotopic ossification in primary cancers and/or their metastases is probably the result of metaplasia of stromal fibroblasts into osteoblasts.     

Prognostically favorable abdominal breast cancer metastases with stomach involvement

BACKGROUND: Abdominal metastases with stomach involvement are rare in breast cancer. The median disease free interval from the time of breast cancer diagnosis to gastric metastasis is usually very long. Treatment is generally palliative, and expected survival time is less than 1 year. CASE REPORT: A 59-year-old woman with breast cancer developed diffuse abdominal metastases involving stomach, abdominal lymph nodes, and omentum 9 years after she underwent mastectomy and adjuvant chemotherapy. The histopathologic diagnosis found by stomach specimen examination was invasive lobular carcinoma, and the cells expressed high levels of estrogen and progesterone receptors. The abdominal metastases were treated with surgery, postoperative chemotherapy, and further hormonal therapy. This was successful, and the patient has been in remission for more than 3 years. CONCLUSION: Once the definitive diagnosis of breast cancer metastases to the abdomen including the stomach is established, treatment that targets systemic breast cancer must be initiated. Our patient's extended survival time suggests that surgical treatment could be considered for selected patients.     

Incidence of stomach cancer in the USSR]

The authors have studied some tendencies in the morbidity and mortality due to malignant neoplasms of the stomach for the period from 1970 to 1975. The age-sex indices of the morbidity are reported as well as some data on a contingency of gastric cancer patients under dispensary control. There is noted a reduced morbidity and mortality rate due to gastric cancer among the population of this country.