Endoscopic picture of stomach cancer

Today the value of endoscopic method in the diagnosis of gastric cancer is not being challenged and recognized by all [Sokolov L. K., 1970; Savinkin Yu. N., 1970; stomach Cancer..., 1977, Kurn M, 1966; Koboyashi S. E. a., 1972]. Thanks to this method became real opportunities for early diagnosis of cancer, or cancer of the early period". According to the classification of the Japanese Association endoscopists there are three basic types of cancer early period (with several subtypes): I - sublime type, this is polypoid cancer and the amount of a polyp not less than 2 cm in diameter; II-surface type of cancer, which is divided into 3 subtypes: a) surface-exalted, b) surface-flat, in) surface-concave. When surface-sublime type is determined visually plate or plaque-like thickening of the mucous on a very limited area. When the surface of a flat type of cancer is the last level of the gastric mucosa into the lumen it is not. Surface-concave type of cancer in the form of small erosion of irregular shape, with a clear border from healthy mucosa and white bloom and bleeding in a day.
Type III - concave type of cancer. Cancer in the form of deep erosion. Can be various combinations of these types of cancer.
All of these types of cancer early period inherent in one circumstance: the invasion of cancer does not go beyond slimy or submucosal layer. Of course, this classification does not cover all varieties of cancers of the early period, but it is convenient in practical terms, and makes an appropriate way to treat sometimes unexpected findings gastroscopy.
The final diagnosis of cancer of the early period is only possible on the basis of data of gastrobiopsy and Cytology, and the more taken pieces of fabric is subjected to the study, the greater the probability of a correct diagnosis. However, it should be emphasized that a negative result does not exclude the diagnosis of cancer. In case of macroscopic picture suspicious for cancer, and the data biopsy reject it, it is necessary follow-up and other additional methods of diagnostics (Cytology).
However, despite the improvement of diagnostic techniques, early cancer is rarely diagnosed. Of 479 patients in whom the diagnosis of gastric cancer was confirmed or diagnosed for the first time, cancer early period, histologically confirmed, was detected in 9 people (1.8%). All other patients were observed more massive invasion of the tumor in the stomach wall with higher prevalence.
Endoscopic picture of the various macroscopic forms of cancer in line with the above classification allows to differentiate the times's personal cancers by type of tumor.
Mushroom (polypoid) cancer looks clearly distinguished education in the form of a polyp on a broad basis, hemispherical shape; this tumor most often wear g hilly nature, often wounded in the apex, with a bleeding surface. The color of such tumors usually purple-brown, with inclusions whitish color and areas of necrosis.
Saucer-like pan. Its dimensions are very varied, and the view of such a tumor so typical that is of diagnostic difficulties. He is "crater" high, bumpy, uneven and very easy bleeding saped edge, uneven seabed, often dirty-gray or brown.
Ulcerative inflammatory cancer is a destroyed the surface of the gastric wall, with a rough, saped and "scalloped" edge. All this education - rounded, or close to this form. Mucous around such ulceration loose, bleeds easily, with multiple small lesions. Ulcer cancer causes the most difficulty endoscopic diagnostics. Sometimes only the entire Arsenal of means and methods of complex diagnostics (re gastrobiopsy, Cytology, homagstrasse, various x-ray methods allow the definitive diagnosis. These patients often completely or almost completely missing the clinic of the disease. Their condition does not cause any suspicion. If they receive any reason conservative treatment, it is often observed nearest short-term effect from him - pitting reduced or even "roboeda".
Diffuse-infiltrative forms of cancer - are much rarer previous three kinds. In this form the wall of the stomach affected over a large area. Visible border of healthy and sick mucous practically absent. The mucosa of grey color, with extensive devastated areas, "lifeless" areas of necrosis and decay. The stomach opening sharply narrowed, peristalsis not.
With extensive lesions are sometimes unable to accurately determine the type of tumor. Mostly, it often happens that the lumen of the stomach is much reduced because of cancer infiltration walls to inflate the stomach is impossible, therefore, to inform the head of the office in relation to the focus of the tumor is sometimes difficult. But in these cases it usually goes about the running forms of cancer, so the exact definition of the type of tumor is of no practical value.