Single article

DOI: 10.47026/2413-4864-2024-4-1-13
Full article

UDC: 57+616.33
BBC: 52.5,53.433,55.6

Diomidova V.N., Efimova O.A.

Rare Histological Types of Malignant Gastric Neoplasms: Features of Histomorphological and Visual Structure

Keywords: malignant neoplasms, stomach, histology, morphology, computed tomography, ultrasound diagnostics

Diagnosing rare histological types of malignant gastric neoplasms causes difficulty due to the nature of tumor growth, the lack of clear cellular differentiation and an extremely rare incidence. The aim of the study is to increase the accuracy of diagnosing rare types of malignant gastric neoplasms using modern methods of radiation diagnosis, depending on their histological characteristics. Materials and methods. The authors examined the data of patients with malignant gastric neoplasms of epithelial (N1, n = 385) and non-epithelial origin – gastrointestinal stromal tumor of the stomach (N2, n = 27), who were diagnosed and (or) treated at the BI «Republican Clinical Oncological Dispensary» under the Health Ministry of Chuvashia and the BI «City Clinical Hospital No. 1» under the Health Ministry of Chuvashia in 2022-2023. The control group is N3 (n = 40). A comparative analysis of data obtained by instrumental diagnostic methods (computed tomography, ultrasound) with a histomorphological description was carried out. Results. Rare histological types of gastric malignancies were identified: gastrointestinal stromal tumor in 6.6% (n = 27), neuroendocrine neoplasias in 3.6% (n = 15), undifferentiated cancer in 3.4% (n = 14), squamous cell carcinoma of the gastric cardia made 2.4% (n = 10). Gastrointestinal stromal tumor, neuroendocrine neoplasias and undifferentiated cancer were predominantly found in the body of the stomach (70.4%, 73.3% and 35.7%, respectively). Squamous cell carcinoma was found exclusively in the gastric cardia, involving the cardioesophageal junction (below the Z-line by 2 cm). G astrointestinal stromal tumor in 55.5% of cases was diagnosed as having a low risk of the disease progression. Neuroendocrine gastric neoplasias in 60% of cases had a low degree of tumor malignancy, and squamous-cell carcinoma of gastric cardia in 60% of cases had an intermediate degree of malignancy. In undifferentiated gastric cancer, cellular differentiation of the tumor was lost. A combined use of radiation diagnostic methods increased their informative value in identifying rare histological types of gastric malignancies: sensitivity – 95.5%, specificity – 98.5%, accuracy – 98.1%. Conclusions. A complex use of radiation examination methods increased the diagnostic accuracy of rare histological types of malignant gastric neoplasms.

References

  1. Gastrointestinal’nye stromal’nye opukholi: klinicheskie rekomendatsii [Gastrointestinal stromal tumors: clinical recommendations]. Moscow, 2020, 45 p.
  2. Gurevich L.E. Osnovnye printsipy novoi klassifikatsii neiroendokrinnykh opukholei zheludochno-kishechnogo trakta i gepatopankreaticheskoi sistemy (VOZ, 2019 g.) [Basic principles of the new classification of neuroendocrine tumors of the gastrointestinal tract and hepatopancreatic system (WHO, 2019)]. Novosti klinicheskoi tsitologi Russia], 2019, vol. 23, no. 4, pp. 27–35. DOI: 10.24411/1562-4943-2019-10405.
  3. Danilova N.V., Oleinikova N.A., Mal’kov P.G. Klassifikatsiya epitelial’nykh opukholei zheludka VOZ 2019 goda, 5-e izdanie [Classification of epithelial tumors of the stomach WHO 2019, 5th]. Arkhiv patologii, 2020, vol. 4, no. 82, pp. 58–69. DOI: 10.17116/patol20208204158.
  4. Diomidova V.N. Vozmozhnosti transabdominal’noi ekhografii v diagnostike raka zheludka [Possibilities of transabdominal echography in the diagnosis of gastric cancer]. Ul’trazvukovaya i funktsional’naya diagnostika, 2007, no. 2, pp. 14–24.
  5. Diomidova V.N. Ul’trasonografiya v diagnostike opukholei zheludka: avtoref. dis. … kand. med. nauk [Ultrasonography in the diagnosis of gastric tumors: Abstract of Cand. Diss.]. Kazan, 1999. 22 p.
  6. Kononov A.V., Mozgovoi S.I., Shimanskaya A.G. Rukovodstvo dlya vrachei. Prizhiznennaya patologo-anatomicheskaya diagnostika boleznei organov pishchevaritel’noi sistemy (Klass XI MKB-10) [Manual for doctors. Lifetime pathological and anatomical diagnostics of diseases of the digestive system (Class XI ICD-10)]. Moscow, Prakticheskaya meditsina Publ., 2019, 191 p.
  7. Limfoma marginal’noi zony: klinicheskie rekomendatsii [Marginal zone lymphoma: clinical recommendations]. Moscow, 2020, 55 p.
  8. Neiroendokrinnye opukholi: klinicheskie rekomendatsii [Neuroendocrine tumors: clinical recommendations]. Moscow, 2020, 87 p.
  9. Lazebnik L.B., Lyalyukova E.A., Dolgalev I.V. et al. Pervye rezul’taty mnogotsentrovogo isledovaniya «RADIUS» (Rannyaya diagnostika raka zheludka pri dispepsii) [The first results of the multicenter study “RADIUS” (Early diagnosis of gastric cancer in dyspepsia)]. Klinicheskaya gastroenterologiya, 2020, no. 5, pp. 8–20. DOI: 10.31146/1682-8658-ecg-177-5-8-20.
  10. Orel N.F., Artamonova E.V., Gorbunova V.A. et al. Prakticheskie rekomendatsii po lekarstvennomu lecheniyu neiroendokrinnykh neoplazii zheldochno-kishechnogo trakta i podzheludochnoi zhelezy [Practical recommendations for the drug treatment of neuroendocrine neoplasia of the gastrointestinal tract and pancreas]. Zlokachestvennye opukholi: Prakticheskie rekomendatsii RUSSCO, 2022, vol. 12, no. 3, pp. 562–578. DOI: 10.18027/2224-5057-2022-12-3s2-562-578.
  11. Besova N.S., Kalinin A.E., Nered S.N. et al. Rak zheludka. Klinicheskie rekomendatsii [Stomach cancer. Clinical recommendations]. Soremennaya onkologiya, 2021, vol. 4, no. 23. pp. 541–571. DOI: 10.26442/18151434.2021.4.201239.
  12. Rak zheludka: klinicheskie rekomendatsii [Stomach cancer: clinical recommendations]. Moscow, 2023, 61 p.
  13. Rak pishchevoda i kardii: klinicheskie rekomendatsii [Cancer of the esophagus and cardia: clinical recommendations]. Moscow, 2021, 70 p.
  14. Agaimy A., Daum O., Markl B. et al. SWI/SNF complex deficient undifferentiated/rhabdoid carcinomas of the gastrointestinal tract: A series of 13 cases highlighting mutually exclusive loss of SMARCA4 and SMARCA2 and frequent Co-inactivation of SMARCB1 and SMARCA2. Am J Surg Pathol, 2016, vol. 40(4), pp. 544–553. DOI: 10.1097/pas.0000000000000554.
  15. Ajani J.A., D’Amico T.A., Bentrem D.J. et al. Gastric Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network, 2022, vol. 2. pp. 167–192. DOI: 10.6004/jnccn.2022.0008.
  16. Ajani J.A., D’Amico T.A., Bentrem D.J., et al. Esophageal and Esophagogastric Junction Cancers, Version 2. 2023, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2023, vol. 21(4), pp. 393–422. DOI: 10.6004/jnccn.2023.0019.
  17. Deng W., Jin L., Zhuo H. et. al. Alcohol consumption and risk of stomach cancer: A meta-analysis. Chem Biol Interact, 2021, vol. 336(109365), November 10, 2024, Amsterdam. DOI: 10.1016/j.cbi.2021.109365. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0009279721000016.
  18. Engevik A.C., Kaji I., Goldenring J.R. The Physiology of the Gastric Parietal Cell. Physiol Rev. 2020, vol. 100(2), pp. 573–602. DOI: 10.1152/physrev.00016.2019.
  19. Gao S., Chen D., Huang L. et all. Primary squamous cell carcinoma of the stomach: a case report and literature review. Int J Clin Exp Pathol, 2015, vol. 8(8), pp. 9667–9671.
  20. Graham R.P., Nair A.A., Davila J.I. et al. Gastroblastoma harbors a recurrent somatic MALAT1-GLI1 fusion gene. Mod Pathol, 2017, vol. 30(10), pp. 1443–1452. DOI: 10.1038/modpathol.2017.68.
  21. Ilic M., Ilic I. Epidemiology of stomach cancer. World J Gastroenterol, 2022, vol. 28(12),1187–1203. DOI: 10.3748/wjg.v28.i12.1187.
  22. Mackintosh C.E., Kreel L. Anatomy and radiology of the areae gastricae. 1977, vol. 18(11), pp. 855–864. DOI: 10.1136/gut.18.11.855.
  23. Nagtegaal I.D., Odze R.D., Klimstra D. et al. WHO Classification of Tumours Editorial Board. The 2019 WHO classification of tumours of the digestive system. Histopathology, 2020, vol. 76(2), pp. 182–188. DOI: 10.1111/his.13975.
  24. Salem M.E., Puccini A., Xiu J. et al. Comparative Molecular Analyses of Esophageal Squamous Cell Carcinoma, Esophageal Adenocarcinoma, and Gastric Adenocarcinoma. Oncologist, 2018, vol. 23(11), pp. 1319–1327. DOI: 10.1634/theoncologist.2018-0143.
  25. The WHO Classification of tumours editorial board. Digestive system tumors. WHO classification of tumors vol. 1. 5th Lyon, France, IARC, 2019, 635 p.
  26. The WHO Classification of tumours, soft tissue and bone tumours. WHO classification of tumors. 5th Lyon, France, IARC, 2020, 635 p.

About authors

Diomidova Valentina N.
Doctor of Medical Sciences, Professor, Head of the Department of Propaedeutics of Internal Diseases with a Course of Radiation Diagnostics, Chuvash State University; Head of the Department of Ultrasound Diagnostics, City Clinical Hospital № 1, Russia, Cheboksary (diomidovavn@rambler.ru; ORCID: https://orcid.org/0000-0002-3627-7971)
Efimova Oksana A.
Radiologist, Republican Oncology Dispensary; Senior Lecturer,
Department of Propaedeutics of Internal Diseases with a Course of Radiation Diagnostics, Chuvash State University, Russia, Cheboksary (oksanalekseevna.e@gmail.com; ORCID: https://orcid.org/0000-0002-0624-4992)

Article link

Diomidova V.N., Efimova O.A. Rare Histological Types of Malignant Gastric Neoplasms: Features of Histomorphological and Visual Structure [Electronic resource] // Acta medica Eurasica. – 2024. – №4. P. 1-13. – URL: https://acta-medica-eurasica.ru/en/single/2024/4/1/. DOI: 10.47026/2413-4864-2024-4-1-13.

Menu

Journal numbers

Archive for year 2024
Archive for year 2023
Archive for year 2022
Archive for year 2021
Archive for year 2020
Archive for year 2019
Archive for year 2018
Archive for year 2017
Archive for year 2016
Archive for year 2015