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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Endoscopic ultrasound (EUS) was performed in 83 patients with gastric cancer to evaluate regional lymph node metastasis. Histopathologic findings were compared with preoperative EUS findings in a total of 1,519 resected lymph nodes. In lymph node staging, the prevalence of metastatic adenopathy was 31.3% (26 of 83 patients); EUS had an accuracy of 83.1% (69 of 83 patients), sensitivity of 53.8% (14 of 26 patients), specificity of 96.5% (55 of 57 patients), positive predictive value of 87.5% (14 of 16 patients), and negative predictive value of 82.1% (55 of 67 patients). The greater the maximum diameter of the node with metastasis, or the larger the ratio of the metastatic area to the cross-sectional area of the node, the higher the detection rate. In tumors classified on the basis of depth of invasion according to the 1987 TNM system, the rate of detection of metastasis in individual nodes was 0% in pT1 tumors (none of five nodes), 20% in pT2 tumors (17 of 85 nodes), 29% in pT3 tumors (20 of 70 nodes), and 10% in pT4 tumors (three of 31 nodes). It is concluded that the most important use of EUS will be in diagnosis of regional lymph node metastasis.
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PMID:Regional lymph node metastasis in gastric cancer: evaluation with endoscopic US. 173 81

Four-hundred eighty-five patients underwent US examination; 183 of them had gastric cancer, 239 colorectal cancer, 38 pancreatic cancer, 11 esophageal cancer, and 14 had gastric lymphoma. All patients underwent surgery. In 95 cases fine-needle biopsy under US guidance was performed. Lymphadenopathies were classified by the criteria proposed by Yoshinaka et al., type I: poorly-defined borders, diffuse internal echoes; type II: well-defined borders, diffuse internal echoes; type III: well-defined borders, notchings, strong internal echoes. Twenty/twenty-nine type I, 66/98 type II, and 39/43 type III adenopathies were found to be neoplasm-positive. Of 73 patients with adenopathy from gastric cancer, 9 were type I, 42 were type II, and 22 were type III (183 patients examined); of 9 patients with adenopathy from esophageal cancer, 7 were type II and 2 were type III (11 patients examined); of 48 patients with adenopathy from colorectal cancer, 5 were type I, 28 were type II, and 15 were type III (239 patients examined); of 29 patients with adenopathy from pancreatic cancer, 7 were type I, 18 were type II, and 4 were type III (38 patients examined); finally, of 11 patients with adenopathy from gastric lymphoma, 8 were type I, and 3 were type II (14 patients examined). The relationship between US and pathology was possible from a statistical point of view only. Type I lymphadenopathies seem to suggest lymphomatous involvement, whereas type III ones suggest metastatic involvement. US is a valid approach method, which must be supported by other investigation techniques--e.g., CT and lymphography--in order to avoid high false-negative percentages.
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PMID:[Echography in the study of adenopathies of the upper abdomen]. 218 42

A 67-year-old man was admitted in October 1987 with complaints of nausea, headache, dizziness and speech disturbance. Hematological examination showed pancytopenia. Bone marrow aspiration failed with a dry tap. A month later, the second aspiration showed hypocellular marrow containing 18.2% of lymphoma cells. Physical examination showed splenomegaly and lymph node swelling. Polyclonal hypergammaglobulinemia was not observed. A lymph node biopsy exhibited typical histology of immunoblastic lymphadenopathy (IBL)-like T cell lymphoma. Surface marker CD3 and CD4 positive cells were dominant. The patient complained of epigastric pain and occult blood was positive in stool. Gastrofiberscopic examination disclosed well differentiated adenocarcinoma in situ located on a polyp, and polypectomy was performed. Lymphoma was treated with cyclophosphamide, doxorubicin, vinblastine and prednisolone. Splenomegaly and lymph node swelling were reduced in size but the effect was temporary. Thereafter the patient has been treated with cyclophosphamide, doxorubicin, vindesine, prednisolone and etoposide every 3 weeks. This is our first case report of IBL-like T cell lymphoma associated with early gastric cancer.
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PMID:[IBL-like T cell lymphoma associated with early gastric cancer: a case report]. 278 12

A 53-year-old man complained of anorexia and abdominal distention of one month's duration. The chest X-ray demonstrated a mass in the left lung with hilar and mediastinal adenopathy and a lytic lesion in the right fourth rib. A transbronchoscopic biopsy of the mass revealed oat cell carcinoma (WHO classification). The endoscopic evaluation also revealed a gastric lesion (IIc type). Biopsy of this lesion indicated signet ring cell gastric cancer. An abdominal CT scan demonstrated multiple liver metastases. Based on these findings, the patient was diagnosed as having synchronous lung and gastric primaries, with liver and bone metastasis from lung cancer. Carboplatin (CBDCA) was administered by intravenous drip infusion of 450 mg/m2. After a second treatment with CBDCA about 3 weeks later, the patient achieved a partial response at the primary site of lung cancer as well as at the liver and bone metastases. In addition, repeat endoscopy of the stomach demonstrated a complete regression. A biopsy specimen taken by gastroscopy was negative for cancer cells. Subsequent chemotherapy for small cell lung cancer was administered with cyclophosphamide, adriamycin, and vincristine, and to date there is no evidence of recurrence. Further studies on CBDCA treatment of small cell lung cancer and gastric cancer are needed to establish the efficacy of this drug against these two histologically different cancers.
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PMID:A case report of synchronous small cell lung cancer and gastric cancer successfully treated with carboplatin. 301 77

The sonographic images obtained in 32 patients with known gastric cancer, who were referred to sonography for evaluation of liver metastases and in whom a specific attempt was made in order to visualize the tumor, were reviewed and evaluated for the extent of exogastric neoplasm. Surgical correlation was available in 21 cases. Sonography allowed identification in five of seven patients who had distant metastases, 12 of 15 who had lymphadenopathy, and nine of 12 patients who had direct spread to structures surrounding the tumor; ascites was always correctly identified. In only one case, a false-positive diagnosis of lymph nodes metastases was made. These results indicate that sonography has good specificity in the staging of gastric cancer and that, when patients are referred for evaluation of liver metastases, it is worthwhile to gather useful additional information about tumor extent by performing a complete sonographic examination of the abdomen and pelvis and by making an attempt to visualize the primary neoplasm and its relations to surrounding organs.
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PMID:Sonographic staging of gastric cancer. 660 Mar 41

We report a case of smoldering adult T-cell leukemia (ATL) with B-cell lymphoma and early gastric cancer. A 64-year-old man was admitted to our hospital because of proteinuria and hypergammaglobulinemia. Systemic lymphadenopathy, "flower cells" in peripheral white blood cells, and hypergammaglobulinemia with monoclonal gammopathy (IgA, lambda type) were found. As Southern blot analysis revealed monoclonal integration of human T-lymphotrophic virus type I proviral DNA in peripheral blood mononuclear cells, he was diagnosed as having smoldering ATL. The tissue specimen of an inguinal lymph node showed proliferation of abnormal lymphocytes which were stained with anti-lambda antibody, indicating B-cell lymphoma. A polypoid lesion in the stomach was histologically diagnosed as early gastric cancer.
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PMID:Smoldering adult T-cell leukemia with B-cell lymphoma and early gastric cancer. 772 76

To overcome the problem of poor mixing of gastrointestinal tract contents with a diluted iodinated contrast agent in abdominal computed tomography, pure water was adopted as an oral contrast agent. In 25 cases of clinically suspected gastric carcinoma, a subsequent pathological examination revealed six cases of early gastric cancer and 19 cases of advanced gastric cancer. We performed CT of the stomach using the following revised procedure: patients were given 600-1000 mL of water by mouth after an intramuscular dose of Buscopan to distend and immobilize the stomach. Gastric mucosal enhancement and the poorer enhanced submucosal layer were demonstrated by a bolus intravenous injection of iodine-containing contrast medium using an automatic injector synchronized with the CT machine. Based on abnormal gastric wall thickening and the abnormal mural enhancement patterns, an accuracy of 96% was attained in differentiating early gastric cancer from advanced gastric cancer, but the detection rates for extragastric invasion, gastric ulcers and lymphadenopathy were 67%, 43% and 63%, respectively. CT staging of gastric cancer was 72%, and was especially accurate for stages I and IV. Water as oral contrast agent for CT of the GI tract was readily accepted by patients and caused no side effects. Using water as an oral contrast for gastric CT is of great help in staging gastric cancer.
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PMID:[Computed tomography of gastric carcinoma using water as a contrast agent]. 790 66

The utility of EUS was evaluated in 27 patients with early gastric cancer undergoing endoscopic mucosal resection over the past 2 years. Accuracy of the assessment of depth of cancerous invasion was studied in 16 patients undergoing EUS before endoscopic mucosal resection. Patients showing no changes in the submucosal (sm) layer or below on EUS included 15 with mucosal (m) cancer and one with sm cancer showing very slight infiltration. Seven patients with m cancer, a negative stump, and no ulcer in the cancer focus at endoscopic mucosal resection, were followed up for more than 1 year after endoscopic mucosal resection. On EUS, four patients showed Ul-IIs changes resembling benign ulcers, two showed Ul-IIIs changes and two showed no changes in the sm layer or below. All patients were negative for cancer in follow up biopsies. No lymphadenopathy was observed. EUS was effective in diagnosing the depth of cancerous invasion in patients undergoing endoscopic mucosal resection and also in clarifying changes in the sm and deeper layers during follow up.
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PMID:[The utility of endoscopic ultrasonography (EUS) in endoscopic mucosal resection of early gastric cancer]. 827 58

The aim of the study was to compare the ability of endoscopic ultrasonography (EUS) in detecting lymph node metastases in differentiated and undifferentiated gastric adenocarcinoma. EUS was performed in 149 patients with differentiated or undifferentiated gastric cancer. Histopathological findings were compared with pre-operative EUS findings in a total of 2961 resected lymph nodes. The EUS detection rates of metastasis to individual nodes in relation to node size, the ratio of the metastasized area to the cross-sectional area of the node and to the depth of primary tumour invasion, were also investigated. The accuracy and negative predictive values of EUS for detecting metastatic lymphadenopathy in each patient were significantly higher for differentiated (87%, 94%) than for undifferentiated (71%, 71%) tumours. The detection rate of individual node metastasis was higher for differentiated (31%) than for undifferentiated (21%) tumours. For differentiated lesions, EUS detected more small nodal metastases (< 5 mm in diameter) (p < 0.01) and more nodes involved with a relatively small proportion of the metastasized area to the cross-sectional area of the node (< 1/3 involvement) (p < 0.05). In relatively superficial lesions, such as pT1 and pT2, the pre-operative EUS detection rate of metastatic nodes was higher for differentiated than for undifferentiated tumours. In conclusion, the ability of EUS to detect nodal metastases is related to the histological type of gastric cancer.
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PMID:Relationship between histological type and endosonographic detection of regional lymph node metastases in gastric cancer. 924 81

The purpose of this study was to evaluate by CT the usefulness of the non-distension of the stomach in determining invasion of the gastric cancer into perigastric space and adjacent organs. Forty-eight patients with pathologically proved gastric cancer were studied by conventional CT. Patients were examined using two techniques: (a) non-distension of the stomach in the supine position and 34 patients additionally in prone position; and (b) distension of the stomach with water or air in the supine and/or prone position. CT findings by both techniques were separately analysed preoperatively and compared to surgical findings. Invasion of perigastric fat was better demonstrated by the non-distension technique in 15 of the 36 patients with pathologically proven fat infiltration. Non-distension technique was more accurate than distension in detecting: (a) involvement of gastric ligaments (80 versus 67% for gastrohepatic, 85 versus 73% for gastrocolic and 80% by both techniques for gastrosplenic ligament); (b) perigastric lymphadenopathy (86% by both techniques for lymph nodes sited at the gastrohepatic ligament, 85 versus 75% for gastrocolic and 85 versus 80% for gastrosplenic ligament lymph nodes, respectively); and (c) pancreatic invasion (86 versus 80%). The prone position with non-distended stomach was particularly helpful in excluding pancreatic invasion in five patients with carcinoma of the gastric body. The distension technique was more accurate in demonstrating perigastric extension in gastroesophageal junction tumors in two patients. In conclusion, additional CT of the non-distended stomach with the patient in prone position can provide further evidence about infiltration of the perigastric fat, ligaments, lymph nodes and pancreas, in patients with gastric carcinoma, with the exception of gastroesophageal junction tumors.
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PMID:Usefulness of the non-distension of the stomach in the evaluation of perigastric invasion in advanced gastric cancer by CT. 993 60


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