RESUMO

The first concrete description of the Gastric Cancer in Early Stage is attributed to the German, M. Versé in 1903, in his book Die Histogenese der Schleimhautcarcinome, but the first to use the term, was the French, Bayle in 1833, calling it First Stage Gastric Cancer. From 1963 to 2002, 5118 gastric cancers were histologically diagnosed, in our hospital from which 2337 (46%) were resected in 340 of the resected specimens, 371 early gastric cancers (EGC) (15.87%) were found. DISTRIBUTION: For every five periods, the number and proportion of early cancers increases, from 10 (6.8%) in the first five years to 78 (21.0%) in the last one. AGE: The average is: 64 years old for men and 58 for women with a global average of 61 years old. The youngest case was in a woman of 23 years old. The oldest case in men was 93 years old, and in women, 81 years old. SEX: 235 males and 105 females, with a ratio of 2,2:1. MACROSCOPY: elevated type: Type l 70 (18.9%) Ila 66 (17.8%) Ila+Ilc 26 (7.0%) lla+l 1 (0.3%) I+lla 0 (0.0) IIa+III 1 (0.3%) IIa+IIb 1 (0.3%). Global average of the elevated type: 44.6%. SUPERFICIAL TYPE: llb 17 (4.6%), DEPRESSED TYPE: llb+llc 10 (2.7%), llc 127 (34.2%), llc+l 0 (0.0%) llc+lll 43 (11.6%) lll 3 (0.8%) lll+llc 5 (1.3%) llc+lla 1 (0.3%) lla+llb 0 (0.0%). The global average of the depressed type is: 50.9%. LOCATION: Antrum 171 (46.1%) body 138 (37.3%) bottom 46 (12.3%) antrum-body 12 (3%) and body-bottom 3 (1%). SIZE: Maximum 90 mm, minimum 1.5 mm, average 24.9 mm; 25 (8%) diminute (microcarcinomas), 58 (21%) small. HISTOLOGY: Differentiated 219 (64%) undifferentiated 121 (36%). Degree of differentiation in men 74% and in women 26%. Degree of differentiation in diminutes 92%, in small 79% and in large 69%. DEPTH: 204(55%) in mucous, 167(45%) in mucous/submucous. In differentiated 182 (63%) in mucous, 108 (37%) in mucous/submucous. GANGLION METASTASIS: In the 187 located in mucous, 13 (3.8%) were positive, in the 153 located in mucous/submucous 30 (8.8%) were positive. Global percentage of positive ganglions: 12.3%. SYNCHRONIC LESIONS: General in synchronic lesions in 54.6% in other types of cancer 12.7%. INTESTINAL METAPLASIA: Present in 65%, of which 50% of them were uncompleted. SYMPTOMS AND SIGNS: Dyspepsia 82.2%, hyperoxia 32.9%, loss of weight 23.3%, non-characteristic pain 23.3%, ulcer pain 20.5%, melena 8.2%, anemia 7.7%, diarrhea and/or constipation 7.4%, vomiting 2.2%, hematemesis 1.9%. BLOOD TYPE: O (63.2%) A (24.7%) B (11.3%) AB (0.6%). GASTRIC SECRETION: This was determined in 70 patients: In 55 with ulcer, none showed achlorhydria 0%, 20 (36%) hypochlorhydria, 20 (36%) normochlorhydria and 15 (28%) hyperacidity. In 16 in an elevated form 13 (87.5%) with achlorhydria, 1 (6.5%) with hypochlorhydria, 1 (6.5%) with normal acidity. Average in ulcerated cases DAB 3.04 +/- 1.25 mEqh and DAM 12.31 +/- 8.00. In elevated cases: DAB 0.89 +/- 0.32 and DAM 2.20 +/- 0.95 mEqh.

Assuntos

Assuntos

RESUMO

Malignant stomach tumors include carcinomas, lymphomas, leimiosarcomas, carcinoids and other less frequent tumors. Adenocarcinoma has been classified in many different ways and by many different authors. Depending on its stage, early or advanced, on one side and according to the TNM staging system (Tumor, Nodes, Metastases) on the other. The early-stage adenocarcinoma, from the macroscopic point of view has been classified in I, IIa, IIc, IIb and III and combinations therefrom. Early-stage cancer has been denominated as O type and advanced cancer, which has been denominated by common practice, as Borrmann: I, II, III and IV, is now numbered using Arabic numbers 1, 2, 3 and 4. Type 5 is included, which would correspond to the non-classifiable carcinoma. Histologic classification according to Lauren, comprises intestinal, diffuse and the mixed or undifferentiated type which produces no mucus. According to Mulligan, it is classified as: pyloric glands and intestinal type cancer on one side and gastric type cell cancer on the other side. The WHO (World Health Organization) classifies them as: Papillary, tubular (tub.1, tub.2 and tub.3) signet ring cell, undifferentiated and mucinous adenocarcinoma. Nakamura, Kato and Hirota classify them as: differentiated and undifferentiated adenocarcinomas. Ming classifies them as: expanding type and infiltrating type. There is a tendency, when dealing with early-stage cancer, to group its forms in ulcerating carcinomas, vegetating carcinomas, localized gastritis-like and advanced-like carcinomas. The gastritis-like classification would correspond to form IIb of the initial classification of early-stage cancer. Broders' classification of Adenocarcinoma grade 1, 2, 3 and 4 is mentioned here as a classification solely on basis of the cellular differentiation. As historical classification, we include that of James Ewing. The above mentioned classifications relate to each other and are not excluding from the conceptual point of view.

Assuntos

RESUMO

En base a los datos clínicos puede alcanzarse un diagnostico razonable hasta en 70 por ciento de casos, sobre todo en la úlcera duodenal

Assuntos

RESUMO

Es dificil precisar cuando comienzan a manifestarse los fenomenos que anteceden al cáncer gástrico, desde que se inician las alteraciones genéticas hasta que la neoplasia alcanza su etapa avanzada se suceden una serie de eventos: fenómenos inflamatorios como la gastritis, erosiones, ulceraciones, hiperplasias, neoplasias benignas como el adenoma, sobre los que se harian presentes lesiones displásicas y luego el cáncer temprano. A travéz el tiempo estos eventos han sido diversamente observados e interpretados, algunas veces, en forma magistral por autores a los que debemos estudios de verdaderos pioneros. Las discusiones han sido multiples y han llegado al apasionamiento. El concepto actual de DISPLASIA y de CANCER TEMPRANO tiene ahora carta de ciudadania

Assuntos

RESUMO

El cáncer gástrico, fundamentalmente epitelial, es de incidencia variable en el mundo; en este trabajo se hace una revisión sobre los aspectos epidemiológicos, hereditarios y ambientales, así como de la importancia de las enfermedades consideradas precursoras; gastritis atrófica y metaplasia intestinal, úlcera gástrica, adenoma gástrico, anemia perniciosa, el estómago operado y la enfermedad de Menetrier. Se describen los cambios patogénicos de la mucosa gástrica que dan lugar a las formas intestinal y difusa del adenocarcinoma del estómago. El aspecto anátomo-patológico incluye las clasificaciones macroscópica de Borrmann y la Japonesa para el cáncer temprano y finalmente se revisan los métodos de diagnóstico clínico y propedéutico, especialmente el radiológico y endoscópico, así como los esquemas terapeúticos de la enfermedad maligana del estómago ya sea, quirúrgicos o quimioterápicos adyuvantes

Assuntos

RESUMO

Presentamos un caso de tricobezoar gástrico diagnosticado en una paciente pediátrica que presentaba tricotilomanía y tricofagia. Se halló además una úlcera gástrica no sangrante en curvatura mayor, hallazgo radiográfico confirmado en el acto quirúrgico en que se extirpó el tricobezoar. Se hace una revisión sobre las características más importantes que acompañan a esta rara patología

Assuntos