Features of endoscopic diagnosis of diffuse gastric cancer.

Abstract

Relevance: Linitis plastica denotes a diffuse type of carcinoma, which accounts for 3-19% of gastric adenocarcinoma. It is characterized by rigidity of most or all of the stomach without a filling defect or extensive ulceration. The article describes the experience of endoscopic diagnostics of patients diagnosed with plastic linitis during 2019-2022 and the 1st half of 2023 at the Center for Expert Endoscopy and Interventional Radiology of the National Research Oncology Center (NROC), Astana, Kazakhstan.
The study aimed to evaluate the features of the use of endoscopic diagnostic methods in diagnosing diffuse gastric cancer.
Methods: а retrospective analysis of diagnosed cases of diffuse gastric cancer in the center of expert endoscopy was carried out from 2019 to the 1st half of 2023.
Results: All patients were initially examined in polyclinics at their place of residence by computed tomography (CT) gastroscopy with biopsy and, upon receiving a negative morphological examination, were sent to us for expert examination and repeated biopsy. The cohort included seven patients (2 men and five women) with an average age of 54.6 years (33 to 71 years). Expert gastroscopy and a special technique for taking biopsy material from the gastric mucosa helped make the correct morphological diagnosis for all seven patients with suspected diffuse gastric cancer. Considering the local and generalized metastases and concomitant pathologies, only four patients underwent surgery, and three were administered only chemotherapy. Five patients have died, and two continue palliative chemotherapy.
Conclusion: Plastic gastritis is a form of adenocarcinoma that usually manifests itself at an advanced stage when drug therapy is usually unsuitable. The prognosis can be improved with complete resection. Surgical intervention should be performed only in cases where complete resection is expected. Expert gastroscopy and the use of a special technique for taking biopsy material (according to J.Rohl) from the gastric mucosa increases the morphological value of biopsies and gives a chance to confirm the diagnosis of diffuse gastric cancer and quickly begin surgical treatment or palliative chemotherapy.