Stomach cancer overview: Difference between revisions
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[[Image:Stomach_diagram.svg|thumb|200px|left|Diagram of the stomach]] | [[Image:Stomach_diagram.svg|thumb|200px|left|Diagram of the stomach]] | ||
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==Classification== | |||
Stomach cancer may be classified into [[adenocarcinoma]], [[lymphoma]], [[gastrointestinal stromal tumor]], and [[carcinoid]] tumor. | |||
==Pathophysiology== | |||
*Gastric [[adenocarcinoma]] is a malignant epithelial [[tumor]], originating from [[glandular]] epithelium of the [[gastric]] [[mucosa]]. It invades the [[gastric]] wall, infiltrating the [[muscularis mucosae]], the [[submucosa]] and hence the muscularis propria. Histologically, there are two major types of gastric cancer (Lauren classification): intestinal type and diffuse type. | |||
**Intestinal type adenocarcinoma: [[Tumor]] cells describe irregular tubular structures, harboring pluristratification, multiple lumens, and reduced stroma ("back to back" aspect). Often, it associates intestinal metaplasia in neighboring [[mucosa]]. Depending on glandular architecture, cellular pleomorphism and mucosecretion, [[adenocarcinoma]] may present 3 degrees of differentiation: well, moderate and poorly differentiated. | |||
**Diffuse type [[adenocarcinoma]] (mucinous, colloid): [[tumor]] cells are discohesive and secrete mucus which is delivered in the [[interstitium]] producing large pools of mucus/colloid (optically "empty" spaces). It is poorly differentiated. If the [[mucus]] remains inside the [[tumor]] cell, it pushes the [[nucleus]] at the periphery - "signet-ring cell". | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 12:51, 31 August 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Stomach cancer (also called gastric cancer) can develop in any part of the stomach and may spread throughout the stomach and to other organs; particularly the esophagus and the small intestine. Stomach cancer causes nearly one million deaths worldwide per year.[1]
Classification
Stomach cancer may be classified into adenocarcinoma, lymphoma, gastrointestinal stromal tumor, and carcinoid tumor.
Pathophysiology
- Gastric adenocarcinoma is a malignant epithelial tumor, originating from glandular epithelium of the gastric mucosa. It invades the gastric wall, infiltrating the muscularis mucosae, the submucosa and hence the muscularis propria. Histologically, there are two major types of gastric cancer (Lauren classification): intestinal type and diffuse type.
- Intestinal type adenocarcinoma: Tumor cells describe irregular tubular structures, harboring pluristratification, multiple lumens, and reduced stroma ("back to back" aspect). Often, it associates intestinal metaplasia in neighboring mucosa. Depending on glandular architecture, cellular pleomorphism and mucosecretion, adenocarcinoma may present 3 degrees of differentiation: well, moderate and poorly differentiated.
- Diffuse type adenocarcinoma (mucinous, colloid): tumor cells are discohesive and secrete mucus which is delivered in the interstitium producing large pools of mucus/colloid (optically "empty" spaces). It is poorly differentiated. If the mucus remains inside the tumor cell, it pushes the nucleus at the periphery - "signet-ring cell".
Diagnosis
Staging
If cancer cells are found in the tissue sample, the next step is to stage, or find out the extent of the disease. Various tests determine whether the cancer has spread and, if so, what parts of the body are affected. Because stomach cancer can spread to the liver, the pancreas, and other organs near the stomach as well as to the lungs, the doctor may order a CT scan, an ultrasound exam, or other tests to check these areas. Blood tests for tumor markers, such as carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) may be ordered, as their levels correlate to extent of metastasis, especially to the liver, and the cure rate.
Staging may not be complete until after surgery. The surgeon removes nearby lymph nodes and possibly samples of tissue from other areas in the abdomen for examination by a pathologist.
Treatment
Like any cancer, treatment is adapted to fit each person's individual needs and depends on the size, location, and extent of the tumor, the stage of the disease, and general health. Cancer of the stomach is difficult to cure unless it is found in an early stage (before it has begun to spread). Unfortunately, because early stomach cancer causes few symptoms, the disease is usually advanced when the diagnosis is made. Treatment for stomach cancer may include surgery, chemotherapy, and/or radiation therapy. New treatment approaches such as biological therapy and improved ways of using current methods are being studied in clinical trials.