□ Fig. 17. Fragment of a microspecimen of the stomach wall. Sclerosed submucous membrane. Arterial type vessel with the wall thickened at the expense of the muscular coat and sclerosed inner coat. Hematoxylin and eosin, x200

roscopically visible thickening of the stomach walls. This feature of early cancer was taken into consideration while studying the stomach by the radiological diagnostic methods. It is evident that these changes require further thorough studies [34, 36, 37].

Diagram 3. Incidence of the three major histological types of gastric carcinomas during the period 1970-

2003 (histological studies of 1440 resected stomachs of patients operated on at MONIKI). This 34-year period is characterized by reduced incidence of the intestinal type of gastric cancer and simultaneously increasing incidence of carcinomas of the diffuse and mixed types

Scheme 1. Gastric glands of the pyloric zone, which are subdivided into three parts - villiform, cervical, and glandular. The generative zone of the glands is located in the cervical part Scheme 2 a,b. Histogenesis of diffuse (a) and intestinal (b) forms of gastric cancer. a Malignant cells of the glandular generative zone (as a result of mutation of genes that are responsible for maintenance of intercellular contacts and protein synthesis by the basal membrane) can migrate into the depth of the proper mucous membrane (bold black) thus initiating diffuse cancer. Figures 1 and 3 represent cancer originating in the fundic glands, Figs. 2 and 4 cancer in the antral glands. b Intestinal type cancer develops in cases where gland fragments containing mutated epithelial cells are obliterated and incorporated into the proper mucous membrane (bold black in 2, 3, and 4). Figure 1 shows mutated cell separation in normal mucosa

D Diagram 3

Number of cases N Number of cases

------x------ mixed type

Five-year periods

D Scheme 1

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