Laboratory methods of research of a cancer of a stomach

Study of gastric contents. The main indicator in cancer of the stomach is decreased secretion. In parallel with the development of cancer indicators of acidity of gastric juice (taken thin tube) is reduced, and often free hydrochloric acid is missing. The tumour localization has also impact on the acidity with cancer of the large and small curvature achlorhydria observed in most patients with cancer of the pyloric or cardia gastric achlorhydria observed less frequently. Known value is given to the study of pepsinogen urine, it marked reduction has a complementary value for the diagnosis of cancer (L. Century Volodarsky, 1968).
Along with this gain value determination of pH juice with the help of sensors-sensors and the pH-meter, as well as histamine, insulin and adrenal tests stimulation of gastric secretion. Detection of lactic acid in the gastric contents currently attached to a small value. Research Ya. M. Bruskin showed that high concentrations of lactic acid is not pathognomonic sign of cancer of the stomach, and indicates the fermentation due to prolonged stagnation of food, in the absence of hydrochloric acid in the gastric juice.
Some value for the diagnosis of cancer of the stomach becomes the defining tetracycline fluorescence juice. For the first time fluorescence tumor tissue under UV light was marked by Rail (1957). Literature data indicate that in stomach cancer observed fluorescence and gastric contents after pre-load tetracycline (May Leay, 1958).

The definition of fluorescence in the fluid from the stomach rengenovskim solution is first to this load, and then the patient give in 5 consecutive days tetracycline 250 000 IU 3 times a day. On the 6 th day of the tetracycline stops, and on the 7th day is again washing stomach on an empty stomach. Received rinsing liquid is neutralized to pH 6 bicarbonate sodium (50,0 per 1000 ml) and centrifuged for 10 min. at 3000 rpm After centrifugation of the surface layer of fluid drained, sludge is placed on obezdolennyh filter paper and dried in air at room temperature. The filter is then illuminated with UV lamp in a dark room and revealed the presence or absence of yellow fluorescence. Tetracycline sample is considered positive if under UV irradiation is observed yellow fluorescence sediment gastric juice. I. P. Kravchuk (1969) has shown the usefulness of this test in the diagnosis of gastric cancer. A. I. Guzeev (1968) installed the portable fluorescence for this sample.

In recent years, cancer diagnostics have been improved by the introduction of cytological study.
For cytological signs of malignant tumors include cellular atypia cell groups, the presence of giant cells and nuclei, polymorphism of cells, change the network of chromatin and more intensive its color, basophilia of protoplasm and often the presence of mitoticescoe cell division. For cytological study are centrifugation wash water stomach. The presence of polygonal cells with brightly colored, sometimes fissile nucleus or elongated cylindrical cells with a nucleus is not at the base, or round cells with large sharply painted by the kernel and vakuolyarnoi protoplasm is characteristic of cancer. With this method, N. K. Shchukarev said even the nature of the structure of the tumor. This method is especially important when the cancer is localized in the upper part of the stomach, where the diagnosis is generally difficult.
Cytological examination of the fingerprints of the tumor, allowing you to more clearly identify the morphological features of cells, deepens the idea about the structure of the tumor and helps sometimes be able to recognize the early signs of malignization of benign tumors.
Even more perfect for early diagnosis of cancer of the stomach is the method exfoliative Cytology mucosa, which increases the shedding of the epithelial cells of the stomach using an abrasive tip-cylinder, "nylon brushes" and so on (Schade, 1960). In Fig. 32 presents characteristic of cancer picture.
Determination of blood in the gastric juice for the diagnosis of cancer is not decisive, as the appearance of blood may be associated with sensing, and besides, she can be and other diseases.

Fig. 32. Malignant cells with hyperchromasia, and increased correctly located nuclei in the lavage of the stomach (Schade, 1960).

Study of metabolic disorders of stomach cancer has some value. When cancer increased blood globulins and a decrease in albumin, an increase of nucleic acids, which is associated with increased tumor proteins, since the stomach is involved in the regulation of protein, water and mineral metabolism and the acid-base balance (I. Ii. Razenkov). Due to the infringement of oxidative processes in cancer patients is reduced allocation through the mucous membrane of the stomach toxic oxidized substances that accumulate in large numbers.
In General lab examination of peripheral blood is noted in cancer acceleration ROHE, which is associated with the physical changes of blood.
Due to having a place in cancer hidden bleeding and thickening of blood because of the violation of gastric evacuation and dehydration can occur matter how paradoxical increase in the number of red blood cells to high numbers in the peripheral blood. Later develops hypochromic anemia.
Find neutrophilic leucocytosis mainly associated with the inflammatory reaction and rotting changes in tumors, especially during its collapse.
The change in the number of platelets (increase) in recognition of gastric cancer is of questionable value. More important than their morphological changes, accumulation among them old items.
Detection of blood in the stool has a role in the detection of gastric cancer. Massive blood loss with progressive progressive anemia occur when polypoid decaying tumors. Small hidden bleeding occur in most cancers, as almost 90% of the time decay of the cancer. To find "hidden" blood is widely used sample of yens Gregersen collection, which is recommended to be repeated several times. It should be remembered that many forms of colloid and fibrous cancers, growing through intact mucous membrane, can stop the bleeding; sometimes prevent bleeding and izyaslavs cancers.