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Radiological Examination in Screening for Gastric Cancer oo

Improvement of the early diagnosis of malignant new growths is among the most important problems in the Russian health-care system. Gastric cancer remains one of the leading pathologies in the structure of oncological morbidity and mortality.

Early diagnosis of gastric cancer is important for the long-term results of treatment. Thus, the 5-year postoperative survival of patients in whom cancer is diagnosed in its early stage is 95-100% [168, 251, 268]. But despite the introduction of endoscopy into practical medicine the diagnosis of gastric cancer has not improved. The early diagnosis of gastric cancer patients does not exceed 1-3%, which indicates a very low efficacy of the existing organizational forms of screening. As before, gastric cancer is detected in patients in its third or fourth stage, when the potential of radical surgery is very low (D Fig. 150). So-called test laparotomies or forced palliative operations are done in 13-28% of cases [76]. In mass-scale examinations of groups at risk

Fig. 151a.

□ Fig. 150a-c. Patient P., age 60. Diagnosis: gastric cancer. a Stomach roentgenogram (vertical position, anterior projection): sign of gas redistribution in the air bubble; the air bubble has the shape of a comma; the stomach walls are thickened (arrows). b Stomach roentgenogram (tight filling, vertical position, anterior projection): the capacity of the stomach is diminished; the stomach is disfigured (rigid tube), it contours are uneven. c Stomach roentgenogram (double contrast, horizontal position, anterior projection): circular infiltration of the distal part and the body of the stomach, marked rigidity of the walls. Conclusion: Infiltrative cancer of the stomach.

□ Fig. 151a-d. Patient N., age 52. Diagnosis: gastric cancer. The patient has no complaints. From anamnesis: gastric cancer patient in the family. a Stomach roentgenogram (tight filling, vertical position, anterior projection): uneven and eroded contour of the greater curvature in the lower third of the stomach body (arrows). b Stomach roentgenogram (double contrast, horizontal position, anterior projection): the walls of the lower third of the stomach body are thickened due to circular infiltration (arrow). Conclusion: Infiltrative cancer of the lower third of the stomach body. c Macrospecimen of the resected stomach: the wall is firm, white intramural infiltration is seen (arrow). d Fragments of the macrospecimen (strips): the stomach walls are thickened due to intramural infiltration (arrows). Histologically, signet-ring cell carcinoma.

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