Portnoĭ L M, Kazantseva I A, Viatchanin O V, Stashuk G A
M. F. Vladimirsky Moscow Regional Research Clinical Institute.
Vestn Rentgenol Radiol. 2003 Jan-Feb(1):4-22.
Data on 1248 cases of stomaches radically operated on for cancer at the surgical departments of the Moscow Regional Research Clinical Institute in 1971 to 2000 were used to study a number of problems associated with cancer of the upper stomach, by regarding the present-day role of radiation diagnosis as of paramount importance. The following radiation diagnostic techniques were assessed. Among them there were traditional X-ray studies (in each case), the new radiation diagnostic techniques: ultrasound study and computed tomography (CT) (750 studies), magnetic resonance imaging (MRI) (120 studies). The potentialities of radiation diagnosis and endoscopy performed in all cases are compared. A specially developed procedure for exploring endophytic forms of gastric cancer was employed in the morphological studies of the material. The incidence of cancer of the upper stomach and its association with the esophagus are presented; some aspects of the morphogenesis of cancer of this site are discussed. The relationship of its clinical symptoms and its radiation image has been studied. In the authors' opinion, the past two decades' rise in the incidence of proximal gastric cancer is one of the main problems in diagnosing gastric cancer that continues holding its stand in the general structure of cancer morbidity. The tendency for diffuse and mixed forms to increase in the morphogenesis of gastric cancer provides evidence that radiation techniques should be actively used in its diagnosis. It is necessary to apply classical double-contrasting X-ray study and endoscopy on equal grounds as basic diagnostic methods at early stages. Only their concord use may change the poor situation associated with the diagnosis of cancer at this site. CT and MRI as additional techniques may substantially provide more required diagnostic information. This is first and foremost associated with difficulties in gastric endoscopic study when esophageal cancer is apparently proved.
利用莫斯科地区研究临床研究所外科1971年至2000年期间1248例因癌症接受根治性胃手术的病例数据，通过将当前放射诊断的作用视为至关重要，研究了一些与胃上部癌症相关的问题。评估了以下放射诊断技术。其中包括传统的X线检查（每例均有）、新的放射诊断技术：超声检查和计算机断层扫描（CT）（750例检查）、磁共振成像（MRI）（120例检查）。比较了所有病例中放射诊断和内镜检查的潜力。在材料的形态学研究中采用了专门开发的探索胃癌内生型的程序。介绍了胃上部癌症的发病率及其与食管的关联；讨论了该部位癌症形态发生的一些方面。研究了其临床症状与放射影像的关系。作者认为，近端胃癌发病率在过去二十年中的上升是胃癌诊断中的主要问题之一，在癌症发病率的总体结构中仍然存在。胃癌形态发生中弥漫性和混合型增加的趋势表明，放射技术应积极用于其诊断。有必要将经典的双重对比X线检查和内镜检查同等作为早期的基本诊断方法应用。只有它们的协同使用才能改变与该部位癌症诊断相关的糟糕状况。CT和MRI作为辅助技术可以大幅提供更多所需的诊断信息。这首先与在明显证实为食管癌时进行胃内镜检查的困难有关。
