El cáncer gástrico en una institución de tercer nivel: correlación endoscópica, por tomografía computarizada e histopatológica del cáncer gástrico en el Hospital Central Militar

Abstract

Introduction

Cancer is the third cause of death in Mexico, and is the second cause of malignant tumour-related mortality, with an incidence that has not declined over the last decades.

Material and Methods

The study included patients who were studied by endoscopy and CT using any protocol due to clinical suspicion of primary gastric tumour lesion in the period from 1 May 2011 to 2 March 2015. Primary gastric tumour diagnosis, as well as other alternative diagnoses, was established by histopathology.

Results

The study included 45 patients, of whom, 28 were male (62%) and 17 were female (38%). Ages ranged from 32 to 86 years. The most common clinical reason was constitutional syndrome, either alone or associated with other clinical symptoms in 18 patients (40%). The gastric cancer was histopathologically confirmed in 30 patients (66%), with 16 (53%) being detected late, with peritoneal carcinomatosis (PC) in 13 (43%), 3 of them with liver metastasis (LM), 1 with venous thrombosis (VT), 2 with LM, and 1 with VT. The gastric CT protocol, with and without contrast-enhanced thoracic images, was performed in 12 patients (27%). Gastric folds thickening was detected in 20%, with concentric gastric thickening in 48% and associated with an ulcerated lesion, PC, LM and VT in 32%. No patients were detected early.

Conclusions

Gastric distension is critical in abdominal imaging and gastric CT represents the ideal imaging technique for gastric cancer staging and classification. The association between constitutional syndrome and gastric cancer reached an elevated rate, with gastric CT being recommendable for the diagnostic approach.