Stomach cancer endoscopy and biopsy: Difference between revisions

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==Overview==
==Overview==
Biopsy may be helpful in the diagnosis of stomach cancer.
[[Biopsy]] may be helpful in the [[diagnosis]] of [[stomach cancer]]. It has a [[Sensitivity (tests)|sensitivity]] of 98% to [[diagnose]] [[gastric cancer]] but may be negative in [[linitis plastica]]. It is commonly used nowadays as first line of treatment for [[superficial]] [[lesions]].  


==Endoscopy and Biopsy==
==Endoscopy and Biopsy==
===Biopsy===
* The [[diagnosis]] of early [[lesions]] appears to be increasing since [[Upper endoscopy|upper gastrointestinal endoscopy]] became widely used.
*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.
* Obtaining seven [[biopsies]] from the [[ulcer]] margin and base have a [[Sensitivity (tests)|sensitivity]] of 98% to [[diagnose]] [[gastric cancer]].<ref name="pmid7054024">{{cite journal| author=Graham DY, Schwartz JT, Cain GD, Gyorkey F| title=Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma. | journal=Gastroenterology | year= 1982 | volume= 82 | issue= 2 | pages= 228-31 | pmid=7054024 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7054024  }}</ref>
**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".
 
 
[[Image:Linitis plastica 2.jpg|thumb|center|200px|Endoscopic image of [[linitis plastica]], a type of stomach cancer where the entire [[stomach]] is invaded, leading to a leather bottle-like appearance.]]


* It may be [[false negative]] in [[Linitis plastica|linitis plastica cancers]].<ref name="pmid7859977">{{cite journal| author=Karita M, Tada M| title=Endoscopic and histologic diagnosis of submucosal tumors of the gastrointestinal tract using combined strip biopsy and bite biopsy. | journal=Gastrointest Endosc | year= 1994 | volume= 40 | issue= 6 | pages= 749-53 | pmid=7859977 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7859977  }}</ref>
* The European guidelines recommend [[endoscopic]] [[resection]] as a [[first-line treatment]] for [[superficial]] [[neoplastic]] [[gastric]] [[lesions]].<ref name="pmid26317585">{{cite journal| author=Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T, Repici A, Vieth M, De Ceglie A et al.| title=Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. | journal=Endoscopy | year= 2015 | volume= 47 | issue= 9 | pages= 829-54 | pmid=26317585 | doi=10.1055/s-0034-1392882 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26317585  }}</ref>
[[File:Por-sig.jpg|300px|center|thumb|Endoscopy shows gastric cancer, source: By Med Chaos - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=15690680]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Disease]]
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Latest revision as of 17:13, 23 May 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

Biopsy may be helpful in the diagnosis of stomach cancer. It has a sensitivity of 98% to diagnose gastric cancer but may be negative in linitis plastica. It is commonly used nowadays as first line of treatment for superficial lesions.

Endoscopy and Biopsy

Endoscopy shows gastric cancer, source: By Med Chaos - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=15690680

References

  1. Graham DY, Schwartz JT, Cain GD, Gyorkey F (1982). "Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma". Gastroenterology. 82 (2): 228–31. PMID 7054024.
  2. Karita M, Tada M (1994). "Endoscopic and histologic diagnosis of submucosal tumors of the gastrointestinal tract using combined strip biopsy and bite biopsy". Gastrointest Endosc. 40 (6): 749–53. PMID 7859977.
  3. Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T, Repici A, Vieth M, De Ceglie A; et al. (2015). "Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline". Endoscopy. 47 (9): 829–54. doi:10.1055/s-0034-1392882. PMID 26317585.

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