Stomach tumors – polymorphic group of the new growths striking all layers of a stomach, having various degree of proliferative activity and influence on health and the patient's life. Refer weakness, an iskhudaniye, discomfort of digestion, appetite loss, anemia, a depression and loss of interest in life to the main symptoms of an oncopathology of a stomach. For detection of tumors use radiological and endoscopic techniques, ultrasonography, KT and MPT of abdominal organs. Treatment of this pathology generally surgical, at identification of a malignant new growth the therapy combined includes also beam and polychemotherapy.
Tumors of a stomach can differ in the nature of tumoral growth, an origin, differentiation degree. Benign tumors occur among all new growths of a stomach no more than in 4% of cases, the vast majority of them – stomach polyps. Among malignant tumors most often reveal stomach cancer; other types of malignant new growths make no more than 5%. A ratio of men and women among patients with an oncopathology of a stomach 3:2. The age level is displaced towards elderly people: more than two thirds - patients are more senior than 50 years. In recent years cancer cases of a stomach considerably decreased, and gastroenterologists connect it with timely identification and an eradikatsiy helikobakterny infection. It is known that H.pylori possesses the leading role in formation of stomach ulcer of a stomach and DPK, and it is long the existing ulcer it is capable to malignizirovatsya and lead to development of cancer of stomach.
Classification of tumors of a stomach
Are divided by degree of a differentiation of a tumor of a stomach on good-quality and malignant. Further division in these groups is carried out as fabric from which there is this tumoral education. Among benign tour tumors the most part is presented by polyps – the ferruterous new growths which are growing in a stomach gleam, having rounded shape, a thin leg or the wide basis. By quantitative criterion allocate a single polyp, multiple polyps, stomach polyposes (the hereditary disease which is characterized by damage of a mucous membrane of bodies of a GIT).
On a structure polyps happen adenomatozny (come from a ferruterous epithelium of a stomach, in 20% of cases are transformed to cancer, especially at the polyp sizes more than 15 mm); hyper plastic (develop against the background of atrophic gastritis, make more than 80% of all polyps, malignizirutsya very seldom); inflammatory (infiltrirovana eosinophils, are not true tumors, but very much resemble oncological process superficially). Separately allocate Menetriye's disease – a precancer state which is described as poliadenomatozny gastritis. Benign tumors of a stomach can come from various fabrics: muscular (leyomioma), submucous layer (lipoma), vessels (angiom), nervous fibers (nevrinom), connecting fabric (fibroma), etc.
The majority of malignant tumors of a stomach (more than 95% of cases) are presented by an adenocarcinoma (cancer of a stomach of an epitelialny origin). Distinguish from other tumors (has neuroendocrine genesis, the tumor is capable to produce hormones), leyomioblasty (comprises the cages reminding both epitelioidny, and gladkomyshechny), leyomiosarky (consists of the transformed gladkomyshechny cages), a malignant lymphoma (comes from the regenerated lymphoid fabric). Less often such tumors of a stomach as fibroplastichesky and angioplastichesky sarcoma, a retinosarkoma, a malignant nevrinoma can come to light.
Reasons of tumors of a stomach
Today the exact reasons of transformation of normal fabrics in a stomach tumor are not established yet. However in gastroenterology the major contributing factors and states which with a high probability lead to formation of an oncopathology are allocated.
The contributing factors at the heart of the are identical both for malignant, and to good-quality new growths. Carry a chronic helikobakterny infection, atrophic gastritis, genetic predisposition (presence of an oncopathology of a stomach at relatives, identification of a gene of SILT-1), improper feeding, smoking and alcoholism, accommodation in a zone of ecological catastrophe to them, immunosupression. Existence of polyps of a stomach (adenomatozny), a resection of a part of a stomach, malignant anemia, Menetriye's disease also contributes to malignant transformation.
Symptoms of tumors of a stomach
Benign tumors of a stomach most often are not shown and found incidentally during inspection concerning other pathology in any way. Polyps of the big sizes can demonstrate the aching pain in epigastralny area after meal; nausea and vomiting with blood streaks; heartburn and eructation; weakness; dizzinesses (against the background of anemia, gastric bleeding); frequent change of locks and ponos. Symptoms leyomiy appear in case of a necrosis of tumoral knot and internal bleeding. In this situation of the patient weakness, pallor, dizzinesses disturb.
Symptoms of malignant tumors of a stomach can arise as against the background of full health, and to accompany symptomatology of stomach ulcer, chronic gastritis. At early stages of cancer of stomach the patient notes a loss of appetite, pains and feeling of refilling of a stomach after food, the progressing iskhudaniye, a perversion of taste and refusal of some products because of it. At late stages of a disease cancer intoxication develops; strengthening of belly-aches against the background of germination is noted by a tumor of the next bodies; vomiting the food eaten the day before; a melena (a chair with the changed blood); increase in regionarny lymph nodes.
Carry a malignization to complications of a good-quality onkoprotsess; germination by a stomach wall tumor with perforation and development of peritonitis; overlapping of a gleam of a stomach a tumoral conglomerate with violation of a passage of a food lump; a tumor ulceration with disintegration and bleeding from tumoral knot; migration of a polyp on a leg in a duodenum with infringement and a necrosis of a polyp.
Malignant tumors of a stomach are also complicated by narrowing of a cavity of a stomach, an ulceration and bleeding, perforation of a stomach. Besides, metastasis, a bystry iskhudaniye with development of a cancer kakheksiya are characteristic of malignant tumors.
Diagnosis of tumors of a stomach
In former years the main method of diagnosis of a tumor of a stomach was the X-ray analysis, however today to the forefront there are endoscopic researches. Nevertheless, it is impossible to deny informational content and ample opportunities of a X-ray analysis – in some clinics it still remains the main diagnostic technique. The survey X-ray analysis of abdominal organs allows to suspect a tumor thanks to deformation of contours of a stomach, shift of the next bodies. For more exact diagnostics contrast researches are used (a stomach X-ray analysis with double contrasting) – during such research various defects of filling demonstrating existence of the tumor growing in a cavity of body or defects of a mucous membrane indicating an ozlokachestvleniye and disintegration of a new growth come to light.
Consultation of the endoscopist is necessary for visualization of tumoral process and purpose of an ezofagogastroduodenoskopiya and an endoscopic biopsy. Carrying out a morphological research allows to establish the correct diagnosis and to begin timely treatment in 95% of cases. For specification of prevalence of a tumoral conglomerate, degree of involvement of surrounding bodies and existence of metastasises performing ultrasonography, KT and MCKT of abdominal organs is possible. Clinical and biochemical analyses give the chance to estimate the general condition of the patient, degree of tumoral intoxication.
Treatment of tumors of a stomach
Tactics concerning treatment of benign and malignant tumors of a stomach differs a little. Removal of benign tumors of a stomach is usually carried out in the surgical way. Concerning stomach polyps gastroenterologists can occupy waiting tactics though the decision on removal of polyps of a stomach at EGDS with simultaneous carrying out an intraoperative histologic research is more often made. Clarification of morphological characteristics of a remote benign tumor allows to make the decision – to make a resection only of a polyp or also adjacent mucous. If during the endoscopic research comes to light total stomach polyposes, the gastrektomiya is made. After removal of a benign tumor the course of treatment inhibitors of a proton pomp, antikhelikobakterny medicines is appointed.
Treatment of malignant new growths of a stomach usually complex, includes surgery, beam and polychemotherapy. Today operation is considered the most effective method of therapy. The volume of surgery depends on many factors: type and sizes of a tumor, prevalence of oncological process, existence and quantity of metastasises, involvement of surrounding bodies, general condition of the patient.
In the presence of a malignant new growth radical operation or palliative intervention can be carried out. Radical operation implies removal of a tumor, a total gastrektomiya, an epiploon resection (omentektomiya) and the surrounding bodies involved in process, lymph nodes. Palliative operations are directed to simplification of the general state and providing an enteroalimentation of the patient. Usually include in a complex of treatment of malignant new growths beam, chemotherapy for achievement of the best result, the prevention of a recurrence of a tumor.
Forecast and prevention of tumors of a stomach
The forecast at identification of good-quality new growths favorable; however, as these tumors are inclined to a retsidivirovaniye, patients are on dispensary observation during all life. Establishment of malignant nature of a tumor considerably worsens the forecast. Chances of recovery are much higher at timely diagnosis and an initiation of treatment of a malignant tumor. At identification of metastasises, germination of the next bodies the forecast for life considerably worsens.
Specific prevention of tumors of a stomach does not exist. For the prevention of formation of an onkoprotsess it is necessary to exclude provocative factors: to adjust a diet, to refuse addictions, to reveal and treat in due time inflammatory diseases of a stomach, to regularly undergo endoscopic inspection with family predisposition to an oncopathology. On reaching 50-year age it is necessary to undergo annually inspection at the gastroenterologist.