The most aggressive form of stomach cancer is signet ring cell carcinoma.

Undifferentiated gastric cancer is a malignant tumor, the source of which is the epithelium of the gastrointestinal tract. Pathology is more common in men - 32% versus 21% in women. The peak incidence is between 40 and 70 years of age. We talk about the causes, symptoms, diagnosis and treatment of the disease.

• 1 Features of low-grade gastric cancer
• 2 Causes of undifferentiated gastric cancer
• 3 Symptoms of the disease
• 4 Diagnosis of undifferentiated gastric cancer
• 5 Useful video
• 6 Treatment of stomach cancer
• 7 Prevention and life prognosis for adenogenic gastric cancer

Causes of undifferentiated gastric cancer

The exact causes of malignant degeneration of gastric epithelial cells are unknown. It has been proven that there are a number of factors that provoke the development of the disease.

1. Burdened heredity. The risk of incidence is higher in people whose relatives had cancer of the stomach, esophagus or intestines.
2. Nutritional features. Abuse of food rich in nitrates, spicy seasonings, and excessive salt. Preservatives, substances formed when foods are smoked, also provoke the development of the disease.
3. Chronic diseases of the stomach: atrophic gastritis, peptic ulcer, gastroesophageal reflux.
4. Pre-tumor processes in the gastric mucosa: adenomas, polyps.
5. Alcohol abuse, smoking.
6. Chronic infection with Helicobacter pylori.

Causes

The most important factor provoking stomach cancer is considered to be poor nutrition with excessive consumption of fried, fatty foods, canned food and marinades. Other reasons are:

• bad habits;
• Helicobacter pylori infection;
• unfavorable environmental conditions of the place of residence;
• long-term use of certain medications;
• influence of ionizing radiation;
• heredity.

The risk of developing signet ring cell cancer of the stomach increases in the presence of chronic gastrointestinal diseases: gastritis, vitamin B-12 deficiency anemia, polyps, ulcers, adenomas, dysplasia, Ménétrier's disease.

Features of cancer

This type of pathogenetic process is, as already noted, in 2nd place in terms of prevalence. Moreover, young people, mainly women, are susceptible to it, which is the main difference from other types of cancer that affect older men.

Based on statistical data, the following features characterizing this type of disease can be noted:

• the tumor is hormone dependent. Almost all male patients with a history of this type of oncology have an increased level of testosterone, and in female patients - estrogen. This factor is direct evidence that the main prerequisite for its occurrence is hormonal disorders;
• this form of cancer affects exclusively young people, aged 35 to 40 years, and is diagnosed more often in the fairer sex - 55% of cases, while in men this figure is 45%;
• Malignant neoplasm of the signet ring cell type has a very high degree of aggressiveness. Its rapid growth in most cases does not make it possible to detect the disease in the early stages, and late detection, when the tumor has already grown into other organs, leaves no chance for a successful prognosis of the ongoing treatment measures;
• a low-quality tumor is not directly related to dietary disturbances. It has the same frequency of occurrence both in those people who eat a balanced diet and in those who abuse spicy, salty and fatty foods and do not follow a diet.

Symptoms of the disease

At an early stage, stomach cancer has practically no specific symptoms, since the small tumor does not disrupt the functioning of the organ and does not affect the condition of the body. If a patient suffers from a chronic gastrointestinal disease, then he gets used to constant discomfort and pain, so it is even more difficult to notice the first symptoms in this case.

Nonspecific signs found in most cancers:

• causeless weight loss;
• fatigue is stronger than usual, which does not disappear even after a long rest.

As the tumor grows, the so-called minor sign syndrome appears - this is a set of symptoms associated with the effect of the tumor on the body:

• decreased appetite, aversion to meat foods;
• gastric dyspepsia: nausea, vomiting, feeling of fullness in the stomach, heartburn;
• periodic pain in the epigastric region.

In approximately 80% of patients with stomach cancer, the disease is asymptomatic for a long time and is detected in late stages.

Pathology Clinic

As is already clear from the description of the pathology, adenogenic gastric cancer is the most aggressive form. The stages and symptoms of the disease change especially quickly. At the same time, it is important to emphasize that even an advanced stage may not have significant symptoms.

In most cases, the pathology develops against the background of peptic ulcer disease. Smoking, dietary errors, and so on can also be provoking factors. Accordingly, the symptoms will be similar to stomach pathologies. It is for this reason that patients are in no hurry to see doctors, which in many cases leads to late detection of cancer.

First signs

Gradually, as the pathology progresses, symptoms begin to appear. Most patients note the following changes:

• constantly present pain in the abdomen of an aching nature, not associated with food;

As cancer develops, aching pain in the stomach appears

• nausea, sometimes vomiting, possible presence of blood impurities;
• change in stool to dark, pasty-like;
• severe weakness;
• loss of interest.

Undifferentiated adenogenic cancer of gastric tissue especially often causes the appearance of common symptoms. As a result of the fact that the degenerated cells no longer fulfill their role, the digestion process is greatly disrupted. As a result, the patient’s body no longer receives all the nutrients required. All this leads to complaints such as increased fatigue, weakness, sleep disturbances, and weight loss.

Poorly differentiated stomach cancer is accompanied by nausea

Cancer patients are characterized by mood changes, which manifest themselves in deep depression, apathy and suicidal tendencies.

In general, at the initial stage, patients may only notice a decrease in appetite and a disturbance in taste. Particularly characteristic of damage to stomach tissue is a complete aversion to all meat products.

If the formation is located in the cardia, complaints such as problems with swallowing may occur. Sometimes spasms occur, causing vomiting. But the most dangerous phenomenon is that if there is a formation in this section, the walls of the stomach begin to involuntarily contract. As a result of this, cells break off from the tumor and spread with the food mass into the underlying parts of the tract, which leads to metastasis.

Patients with stomach cancer report difficulty swallowing

Late stage symptoms

At the third and final stage of the pathology, the clinic is brighter. As the size of the formation increases, the pain increases and becomes unbearable. When neighboring organs are involved, pain of a different nature may occur, for example, girdling pain or radiating to the back.

It is also possible that cancer cells spread to the tissue of the diaphragm. In such a situation, the clinic will be similar to pathologies of the heart and lungs. But when the intestines are involved, constipation appears and bloating may be a concern. At the same time, the latter symptom can also be caused by liver damage. In such a situation, yellowing of the skin and change in the color of urine also occur.

Progressive tumor growth can cause bleeding. This condition is an absolute indication for hospitalization.

Constipation occurs in advanced stages of cancer

Poorly differentiated formations are almost always detected at later stages in the presence of metastases. Patients come in especially often when they have stage 3 stomach cancer. Accordingly, the prognosis for the pathology is unfavorable. If it is possible to identify abnormalities at an early stage, for example, during a preventive examination, then patients can only agree to surgery and subsequent chemotherapy. Without this, it is impossible to get rid of metastases.

Diagnosis of undifferentiated gastric cancer

The final diagnosis of low-grade gastric cancer is made only based on the results of cytological and histological analysis performed by a pathologist. To do this, a biopsy of the tumor is performed during gastroduodenoscopy. The resulting tissue sample is sent to the laboratory where, after special processing and staining, the doctor examines it under a microscope and makes his conclusion.

In addition, to clarify the stage of the disease and the extent of the oncological process, the following diagnostic examinations are carried out:

Esophagogastroduodenoscopy. An endoscopic method that allows you to examine the gastric mucosa from the inside using a gastroscope. Allows you to assess the size of the tumor and perform a biopsy.

X-ray of the stomach, esophagus and duodenum. X-ray images of the stomach and abdominal cavity in various projections. During the study, a suspension of barium sulfate is used as a contrast agent, which improves diagnostic accuracy. A stomach tumor is visualized as a filling defect in the organ cavity.

Ultrasound examination of the abdominal cavity. Used to assess the involvement of the abdominal organs in the pathological process.

Multislice computed tomography. Allows you to identify metastases in other organs.

Positron emission tomography. The method is used to identify the exact localization of the tumor process. Radioactive glucose is injected into the patient's blood, which predominantly accumulates in cancer cells due to the peculiarities of their metabolism. Areas with increased radioactivity will be visible in the images.

Treatment of stomach cancer

The choice of the optimal method of therapy is made by an oncologist. This takes into account the stage of the disease, the presence of metastases, biopsy data, age and general health of the patient.

Three main methods of treating cancer.

1. Surgical removal of the tumor and metastases. Depending on the stage of the process, resection of part of the stomach is performed (stage 0–1) or complete removal of the organ, part of the lesser omentum, along with revision of regional lymph nodes. The consequence of surgery is a significant reduction in the volume of the stomach; in case of significant damage, the esophagus is directly connected to the small intestine.
2. Chemotherapy. It is carried out by introducing special drugs. Allows you to suppress the growth of metastases and prevent relapse of the disease. The problem with chemotherapy is that in addition to tumor cells, normal cells of the body are also exposed to toxic effects. This leads to significant side effects: nausea, diarrhea, hair loss, inhibition of the hematopoietic system.
3. Radiation therapy. Performed in the postoperative period to destroy remaining cancer cells.

Often a combination of several methods is used, for example, surgical removal of the tumor is combined with subsequent chemotherapy or radiation treatment. This allows you to kill tumor cells remaining after resection and suppress the development of metastases.

An important condition for successful treatment is rehabilitation after courses of treatment. It includes enhanced nutrition (in accordance with the prescribed diet), vitamin therapy, the use of adaptogens and immunomodulators. In the absence of appetite, the introduction of special nutritional mixtures with increased calorie content or intravenous administration of nutrients is indicated.

Recovery after treatment

Since surgical treatment of stomach cancer involves complete or partial removal of the organ, the patient will face serious dietary restrictions, since the main burden falls on the small intestine. Therefore, the patient is prescribed a gentle diet, excluding the consumption of coarse, fatty and indigestible foods.

Particular attention is paid to the daily routine. The patient is advised to get plenty of rest and limit his workload in terms of daily activities. At the same time, it is advisable to maintain communication with loved ones, as this has a beneficial effect on the psycho-emotional state.

Prevention and life prognosis for adenogenic gastric cancer

If a tumor is detected at the stage of local growth, when the oncological process is limited to the mucous membrane of the organ, the survival rate of patients is 85–90%. In the presence of metastases to neighboring organs, 15–30% of patients survive. When cancer is detected in the last 4th stage, the survival rate of patients does not exceed 5%.

Poorly differentiated gastric cancer is an oncological disease with a high probability of early metastases. The structure of a tumor growth with the formation of pathogenic foci does not depend on the tissue type of the organ. This tumor is characterized by a high level of malignancy. The previous type is moderately differentiated squamous cell carcinoma. The prognosis for life with a poorly differentiated tumor is disappointing.

Survival prognosis

In general, for stomach cancer, the five-year survival prognosis at different stages is as follows:

• if the cancer does not spread beyond the stomach - 68%;
• if the tumor has spread to neighboring organs or regional lymph nodes - 31%;
• if distant metastases of cancer are detected - 5%.

Signet ring cell tumors are often diagnosed at advanced stages and have a poor prognosis. In each specific case, this issue should be discussed with the attending oncologist individually.

Symptoms of stomach cancer

With stomach cancer, the patient's symptoms manifest themselves differently, depending on which organ is affected by the malignant process. If the human body has come under the influence of negative factors that have caused the pathological development of signet ring cells, the person will find the following signs:

• characteristic heaviness in the stomach after eating;
• discomfort in the organ;
• burning, painful sensations of an acute or dull nature;
• constant nausea, vomiting;
• the body rejects a number of products - meat products, poultry, etc.;
• decreased or loss of appetite;
• a person becomes full after eating a small amount of food;
• there is a strong decrease in body weight;
• an apathetic and melancholic state is observed;
• Fatigue and fatigue quickly appear;
• elevated body temperature without detecting a characteristic symptom;
• aggression and irritability.

Undifferentiated gastric cancer poses a serious threat due to the symptoms it presents. Specific signs of ongoing pathology appear only at the final stage. The last stage is not treatable, and treatment is not effective in combating signet ring cells. The sign does not differ in comparison with the manifestations of other types of gastric cancer. However, these symptoms are aggressive in nature, become more pronounced and intensify quickly.

Diagnostics

Diagnosing adenogenic low-grade cancer, especially in the early stages of development, is difficult. To identify a pathological process, it is necessary to carry out full-fledged research procedures. Laboratory and hardware examinations make it possible to identify pathogenic tissue down to the smallest nuances. The most accurate and definitive diagnosis ensures highly effective therapeutic treatment. Effective and competent therapy is selected. Diagnosis of a cancerous tumor is represented by the following research option:

• Gastroscopy (fibrogastroduodenoscopy) is a research method that helps to examine the mucous tissues of the stomach. At the discretion of the doctor, a biopsy of material where malignant adenocarcinoma may occur is performed. To perform the procedure, a specific device is used - a probe, which includes an optical fiber. A video camera, a light source and a manipulator have been added to the instrument. Thanks to the device, the doctor is able to examine the tumor formation through the image on the monitor, determine the size of the lesion, and see how intensively the pathogenic cell has spread through nearby structures. If necessary, during the procedure, a sample of material is taken for subsequent laboratory testing.

• Histological examination is an examination method that gives a final diagnosis. The clinical laboratory analyzes the biomaterial taken during the biopsy. A poorly differentiated type of cancer is characterized by special forms and specific structural features of cells.
• Extended blood test - to confirm a poorly differentiated tumor, the presence of a tumor marker that determines the pathogenic disease is assessed.
• Contrast radiography is a method aimed at obtaining an image of the internal flora of the stomach. To carry out the procedure, a contrast agent is used to fill the organ tissue. The method helps to determine the altered state of tissues in the stomach and assess the intensity of the impaired functioning of the body.
• CT, MRI and PET are research procedures that provide a clinical picture of the condition of the patient’s internal cavity. Using methods, it is possible to determine the existence of regional and distant secondary lesions with metastases.
• Ultrasound – Ultrasound examination reveals signs of metastasis.
• Diagnostic laparoscopy - examination is prescribed when diagnosing cancer at a late stage of development. The purpose of the procedure is to identify metastases in the abdominal cavity and liver.

Diagnosis of oncological pathologies plays an important role in the speed of examination procedures. Over time, the disease worsens, and any missed day favors the development and spread of the pathological focus.

Diagnostic methods

Cricoid cancer of the stomach can be suspected upon examination and palpation of the abdomen. Tumors can be palpated only in severe stages of the malignant process. Laboratory testing includes:

• General blood analysis. Determines a drop in the level of hemoglobin, red blood cells, and a pathological increase in ESR.
• Biochemical examination. Shows changes in liver tests, excess of C-reactive protein.
• Coprogram. Detects mucus, the presence of blood elements, and abnormal inclusions in stool.
• Blood test for tumor markers. Determines the excessive concentration of pathological proteins that are synthesized in stomach cancer.

Instrumental techniques

1. Fibrogastroscopy is a visual examination of the gastric mucosa. Necessary to determine the location of the tumor, its spread and boundaries. In this case, a biopsy is taken for further microbiological examination. This is necessary to make a diagnosis of signet ring cell carcinoma.
2. X-ray with contrast. An examination that shows the primary malignant source, the functioning of the digestive system and the degree of absorption of the contrast agent.
3. Ultrasound of the abdominal organs and lymph nodes is performed to determine the spread of carcinoma and identify areas of metastasis.
4. CT and MRI are diagnostic measures that study stomach cancer layer by layer. The results show all the physical characteristics of the formation, the type of blood supply, the number and location of metastases.

Treatment

Treatment for undifferentiated gastric cancer requires the use of modern and latest techniques. An integrated approach to oncology treatment is recommended. This way, a person gets a better chance of curing cancer, stopping the spread of affected cells into neighboring tissue, and filling his own body with energy for the difficult fight against pathology. The likelihood of a full recovery for the patient increases. It is better if the disease is detected at an early stage.

Therefore, a person should regularly undergo examination of body organs and undergo tests. It is important to be examined by a doctor on time and follow medical recommendations. If pathological disorders are detected in the body, it is recommended to undergo additional examinations. An additional procedure will rule out or confirm the presence of cancer in the cells. To select the appropriate treatment for undifferentiated stomach cancer, the doctor is based on the results obtained. Treatment is divided into methods:

• Radiation therapy – therapy is performed using ionizing rays. The use of a radiation procedure is prescribed after surgery to excise residual pathogenic tissue. Irradiation is carried out remotely or in the internal area. It is also possible to carry out complex radiation therapy, including both types of radiation.
• Chemotherapy is a common and well-known treatment for cancer. The technique involves the patient taking cytostatic drugs. These drugs can be prescribed in the form of a tablet or introduced into the body by injection. In some situations, medications are administered intravenously or into an artery. The doctor conducts the technique of using medicinal drugs. Depending on the body’s perception and reaction to the medication taken and the effectiveness of the prescribed method of taking the medication, the effect of chemotherapy on the victim’s organs is determined.
• Biological therapy - the meaning of the method is determined by the use of special vaccines. The vaccine is carried out using modern nanosubstances and monoclonal antibodies. This form of therapy began to be used not so long ago. The treatment has a positive effect on the patient’s health during the fight against pathogenic tissues.

When visiting a medical facility at a late stage of the disease, the patient does not undergo surgery. For low-grade gastric cancer, surgery is more effective. Therefore, the development of an undifferentiated type of disease reflects a disappointing prognosis. If the oncological process can be identified at the initial stages, a high probability of cure from the pathology is guaranteed.

Therapy

There are several ways to treat signet ring cell cancer of the stomach.

Surgery

This is the main method of treating the disease. Surgery is prescribed only if the disease is detected at the initial stages of development. The essence of the procedure is partial resection of the stomach with amputation of a malignant tumor. As a result, most of the organ is preserved, and subsequently the stomach normalizes its activity.

Treatment of signet ring cell cancer of the stomach with this method is also possible at the third stage of development of the pathology. However, in this case, a complete resection of the organ is performed, as well as lymph nodes and all affected tissues and parts of organs. After this, the patient is provided with artificial feeding channels.

At the fourth stage, only secondary foci of pathology are removed. This alleviates the patient's condition, but does not eliminate cancer.

Chemotherapy

Chemotherapy prevents the spread of the disease and prevents the disease from recurring. The essence of the manipulation is taking special drugs that have the ability to destroy cancer cells. After this procedure, the growth of the tumor stops and its destruction occurs.

Side effect is alopecia. However, hair growth resumes as the drugs are removed from the body.

Radiation therapy

This procedure is carried out before surgery or after surgery. The essence of the manipulation is the introduction of photosensitizing substances into the foci of pathology, followed by laser treatment of the seals.

Forecast

Poorly differentiated gastric carcinoma g3 is aggressive in nature and is characterized by accelerated spread throughout the structures. And in the treatment of cancer, a disappointing result is predicted due to the unpredictability of the behavior of the pathology. In most cases, the patient is admitted to the hospital with a late stage tumor. Metastasis is observed in the lymph nodes and blood.

The development of a tumor with metastases can be stopped temporarily. If cancer was diagnosed at stage 1, the survival prognosis and five-year life expectancy reach 90%. People cured of oncology are recommended to maintain proper nutrition throughout their lives and undergo regular examinations by an oncologist. A patient with stage 2 poorly differentiated tumor has a 55% chance of survival.

The result depends on the time of stopping the metastasis process. Stages 3 and 4 of low-grade cancer are often not treatable. Palliative therapy helps to increase the life expectancy of patients and improve the condition of the body; patients live their previous routine. Here the five-year life expectancy reaches 15-30% of cases. Glandular cancer of the stomach ranks 4th in mortality among patients.

Pathology prognosis

As already mentioned, the prognosis for this form of cancer is unfavorable. This is especially true in cases where pathology is detected at stages 3-4. As a rule, the treatment only allows to stop the growth of the formation, but does not get rid of it. If it is possible to identify the disease at the first stage, then nine out of ten patients are completely cured. At the same time, they are required to constantly follow a diet and undergo regular examinations.

At the second stage of the pathology, cure is possible in 50% of cases, but again, subject to well-chosen treatment. But at the third and final stage, cell cancer is no longer curable. All measures are aimed only at alleviating the patient’s condition.

The video contains detailed information about methods of treating stomach cancer:

Preventive measures

It is difficult to prevent the development of cancer pathologies. A person must exclude the negative influence of provoking factors on the body, which are the reasons for the modification of healthy tissue into malignant tissue. Cancer prevention involves simple recommendations:

• stop drinking alcoholic beverages and tobacco products;
• drink only filtered water;
• consume less red meat products;
• limit the consumption of fatty, fried, salty and spicy foods, and also remove preservatives from the diet;
• limit protein intake;
• add vitamins A, C and E and carotene to the diet;
• eat more fresh fruits and vegetables, don’t forget about greens;
• avoid overeating;
• protect the body from the action of carcinogenic elements;
• treat serious illnesses;
• Constantly see a doctor and undergo a preventive examination every year.

Compared with well-differentiated variants, undifferentiated cancer is characterized by faster and more aggressive growth, early metastasis, as well as frequent recurrence and a worse survival prognosis.

Stomach cancer is a disease that concerns many people. Thousands of scientists around the world are developing new methods for treating oncology. In order to allow doctors to plan the necessary treatment and more likely establish the correct diagnosis, a classification of stomach cancer according to degrees of differentiation was created.

The degree of differentiation is determined by microscopic examination based on what the tumor cells look like and what activity they exhibit.

Adenogenic stomach cancer: symptoms and manifestations

There are 4 types of cancer, depending on the degree of cell differentiation:

• well-differentiated gastric cancer. Such neoplasms are of low malignancy, their cells are practically no different from healthy ones, so the prognosis for them is favorable;
• moderately differentiated gastric cancer. It belongs to the average degree of malignancy and is, so to speak, a transitional form;
• low-grade gastric cancer. Cells of poorly differentiated formations have lost almost all similarities with normal tissue. They actively multiply and spread throughout the body;
• undifferentiated. The cells are completely atypical, do not resemble healthy ones in any way and cannot perform their functions. They just receive nutrients and constantly divide. Quite often, specialists cannot determine the histogenesis of the tumor. Adenogenic neoplasms are the most aggressive form of oncology, the cells of which are incapable of differentiation.

Features of undifferentiated types of gastric carcinoma:

• rapid rates of growth and metastasis;
• predominance of infiltrative growth (expansive forms are practically not found). The tumor does not have clear boundaries and spreads over a wide area;
• are more often localized in the proximal part of the stomach, or completely affect the entire organ;
• the structure of which the tumor consists has a loose growth pattern. Parenchyma predominates over stroma;
• The cell nuclei are irregular in shape and differ in size from each other.

Prevention methods

Preventive measures to reduce the risk of signet ring cell cancer are:

• getting rid of bad habits;
• balanced diet;
• timely treatment of chronic gastrointestinal pathologies;
• regular preventive examination (especially after 40 years of age);
• genetic testing for familial gastric cancer;
• minimizing stressful situations;
• sufficient level of physical activity.

Signet ring cell cancer of the stomach is an aggressive type of malignant gastrointestinal pathology. As with all cancers, treatment and prognosis are most optimistic when the disease is detected in the early stages. The terminal stage can only be alleviated by palliative therapy.

Source

Types and types of undifferentiated stomach tumors

Forms of undifferentiated stomach cancer:

• solid cancer, also known as trabecular. The tumor has a dense structure. Consists of trabeculae of cancer cells that do not have a glandular structure, which are located between connective tissues;
• scirrhus (fibrous cancer) is represented by hyperchromic cells that settle between strands of coarse fibrous tissue;
• mucous cancer (ring cell, colloid), is characterized by the production of large amounts of mucus, which in volume reaches more than half of all other tissues. The structure resembles a mucous mass, in which mutation cells similar to rings are difficult to detect, which is how they got their name.

Interesting fact! In the stomach, undifferentiated variants of adenocarcinoma, small cell and large cell cancer are found.

Prognosis and prevention

The prognosis depends on the stage, but most often it is unfavorable. The five-year survival rate ranges from 15-18%. Considering that a tumor most often develops against the background of existing stomach problems, to prevent its development and timely diagnosis of precancerous conditions, it is recommended to undergo regular examination by a gastroenterologist.

The presence of highly qualified oncologists and related specialists on the staff of the European Clinic allows us to select the optimal treatment. The use of the most modern treatment protocols allows us to achieve satisfactory results even in the most difficult cases.

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One of the morphological characteristics of malignant neoplasms is the degree of their differentiation. Cell differentiation is the implementation of the genetic program embedded in them, thanks to which their development occurs and the ability to perform specialized functions. During malignant transformation, differentiation is disrupted, signs of atypia appear, and tissue structure is disrupted. In undifferentiated tumors, the changes are so severe that they cannot be identified with any tissue. Such cells cannot perform any functions except nutrition and reproduction.

Undifferentiated adenogenic gastric cancer is a malignant tumor that has pronounced signs of atypia, is characterized by a malignant course, a tendency to rapid metastasis and local spread.

Undifferentiated gastric cancer is a malignant tumor that has pronounced signs of tissue atypia, is characterized by an extremely high malignant course, and a tendency to rapid metastasis and local spread.

Causes of undifferentiated gastric cancer

The causes of adenogenic stomach cancer are related to the standard of living of the population. During research on this matter, it was noted that this disease appears more often in poor people and less often in wealthy people. The decisive role in this is played by the nature of nutrition and lifestyle.

The risk of developing cancer increases with excessive consumption of carbohydrates, salty foods, fish, as well as due to a lack of vitamins and microelements. The quality of water and food that a person eats is of no small importance. High levels of nitrites and nitrates, which contribute to cancerous transformations, are bad for the stomach. Scientists also point out the harm of smoking and alcohol.

Interesting fact! It has been proven that the diffuse type of carcinoma can be inherited.

Internal risk factors include:

• the presence of duodenogastric or gastroesophageal reflux in a person;
• impaired absorption of nutrients;
• genetic abnormalities.

When the mucous membrane is damaged by one or more of the above factors, the likelihood of infection with the bacterium Helicobacter pilory increases. The presence of this microorganism in a person increases the risk of carcinoma by 10-12 times! Helicobacter pylory causes inflammation against which mutations and genomic rearrangements can occur in the cells of the mucous membrane. It should be noted that these processes take 30-40 years.

Also, ailments such as gastritis and ulcers, which are precancerous conditions, are closely associated with poor diet and the H. Pilory bacterium. Chronic gastritis turns into cancer in 75-80% of cases if left untreated for a long time.

Causes and risk groups

The reasons for the development of adenogenic gastric cancer are not fully understood. What is known for certain is that a healthy cell degenerates into a malignant one under the influence of oncogenic processes or mutations. The following factors can lead to their occurrence:

• Chronic gastritis of atrophic type. In this case, the localization and extent of its spread are important. If foci of gastritis are localized in the body of the stomach, the risks increase by 3-5 times, with damage to the antrum - by 18 times, and with total damage, the risks increase by 90 times.
• Features of the diet include consuming a large amount of spicy foods, smoked foods, marinades, and alcohol.
• Helicobacter gastritis.
• Smoking.
• A history of gastric surgery.
• Hereditary predisposition.
• Working with carcinogenic substances - asbestos, chemical production, etc.

The risk group includes people with stomach diseases, such as gastritis, polyps, ulcers. In order to detect the development of cancer in time, they are recommended to undergo regular examination by a gastroenterologist.

Symptoms of adenogenic stomach cancer

Most cases of gastrointestinal cancer are detected at late stages, which makes it impossible to carry out radical therapy, thereby reducing the patient’s chances of recovery.

Symptoms are divided into two groups:

• local;
• are common.

Local signs include:

• pressing pain in the stomach;
• heartburn;
• belching air with an unpleasant odor;
• dysphagia (depending on the location of the tumor);
• lack of appetite;
• change in taste preferences, aversion to previously favorite foods;
• satiation with a small amount of food;
• nausea and vomiting (sometimes bloody).

Common symptoms of undifferentiated stomach cancer include:

• sudden weight loss;
• anemia;
• apathy and weakness;
• temperature increase;
• nervousness, absent-mindedness.

How does the disease manifest itself?

Often the disease does not manifest itself at all in the first two stages. This is why signet ring cell cancer of the stomach is detected at stages 3 and 4. Symptoms occur as the tumor grows in width and depth.

The main signs of this type of cancer:

• rapid satiety after eating, heaviness in the stomach due to a tumor;
• the appearance of nausea, vomiting, bloating, diarrhea, constipation;
• belching air, frequent heartburn;
• constant fatigue, drowsiness;
• elevated body temperature.

Digestion worsens, metabolism is disrupted. The body lacks vitamins and microelements. Hemoglobin levels drop. Hair loss and dryness, pale skin, and weakness are observed. A person experiences constant aching pain in the stomach, which does not depend on food intake.

Diagnosis and treatment of adenogenic cancer

There are no particular differences in diagnostic methods between various forms of gastric carcinoma. Initially, standard studies are carried out to identify symptoms of the disease: complaints and anamnesis are collected, external examination, palpation, percussion, etc. are carried out.

Patients with gastric cancer usually complain of one or another gastric disorder, as well as abdominal pain, loss of appetite, weight loss, general weakness and malaise. Depending on the stage of the disease, the general appearance of the patient changes: the skin turns pale, becomes dry, facial features become haggard, eyes become dull.

During palpation, pain is observed in the epigastric region. It is possible to palpate a stomach tumor in rare cases, but metastases in the lymph nodes, liver and lower abdomen can be detected.

The symptoms of adenogenic stomach cancer are very similar to gastritis or ulcers, so further examination is required to establish the correct diagnosis.

Doctors usually prescribe a number of tests:

• blood test. It will show the presence of anemia, proteinemia, leukocytosis, blood clotting disorders, changes in the level of protein, albumin and other substances. Although in the initial stages of the disease there may not be any significant changes.
• fluoroscopic examination. With its help, you can identify the presence of a tumor or signs indicating it, namely: irregular relief of the mucous membrane, thickening of its folds, erosion, defect in the filling of the stomach, retention of the contrast agent, narrowing of the lumen or outlet. The use of the latest radiographic techniques makes it possible to detect cancer in 80% of cases;
• endoscopic studies (FGES). This is an advanced method for diagnosing stomach cancer, which allows for a differential diagnosis and detection of a tumor at an early stage. Also, using FGES, it is possible to perform a biopsy with further histological and cytological examination, which is mandatory for verifying the tumor. After a biopsy, it will be possible to confirm that the tumor is undifferentiated.

If oncology is detected in the stomach, laparoscopic examination, CT and ultrasound of the abdominal cavity, liver scanning, lymphography and angiography are performed. All these methods are used to find out how far the tumor has grown and determine further treatment.

Stages

Signet ring cell cancer goes through several stages in its development.

Treatment of adenogenic stomach cancer

Treatment for malignant stomach tumors may include:

1. An operation whose purpose is to remove the part of the organ affected by the tumor and the surrounding lymph nodes, since they may contain metastases. This is called subtotal resection. In advanced cases, the stomach may be completely removed (this is called a gastrectomy). If there are metastases in surrounding organs, then the operation is complemented by their removal.
2. Chemotherapy. It involves the introduction of cytostatic drugs that inhibit the growth of a malignant neoplasm.
3. Radiation therapy (exposing the tumor to radiation, which destroys its cells).

The best treatment for undifferentiated gastric cancer is considered to be complex therapy with mandatory surgical intervention. Indications for resection are determined based on the size, location and shape of tumor growth, as well as its degree of spread to surrounding tissues and structures.

One of the important problems in the treatment of stomach tumors is the inoperability of the patient. Late diagnosis is considered the main reason for inoperability. Often, a tumor is found when it has already grown beyond the affected organ and the process of metastasis has begun. Then it is not possible to completely remove the tumor.

With adenogenic types of cancer, an additional difficulty arises associated with infiltrative aggressive growth. Even an experienced specialist will not be able to clearly determine the boundaries between affected and healthy tissues. Therefore, more than half of all diagnosed patients are classified as inoperable.

In addition, radical treatment is contraindicated for people with severe exhaustion or obesity, concomitant pathologies (diabetes mellitus, renal failure, etc.). This is due to the complexity of surgical interventions on the stomach. The operation sometimes causes complications and even death in patients.

In such situations, palliative treatment is prescribed in the form of operations to remove part of the tumor, install a bypass anastomosis between the stomach and intestines, or apply a gastrostomy. This eliminates complications that are often observed in such patients: dysphagia, pyloric stenosis, bleeding and tumor disintegration.

Also, if radical surgery for stomach cancer is not possible, palliative chemo-radiation therapy is used. This approach only slightly increases life expectancy, but can have a beneficial effect and improve the general condition of the patient. Sometimes it is even possible to achieve the tumor becoming resectable.

Although adenogenic cancer is poorly susceptible to chemotherapy, it is often used in the postoperative or preoperative period to reduce the likelihood of disease relapse and increase the effectiveness of gastric resection.

The following were recognized as the most effective:

• 5-Fluorouracil;
• platinum preparations;
• Etoposide;
• Adriamycin;
• Mitomycin.

They are combined in various schemes. Chemotherapy courses for stomach cancer are repeated several times before and after surgery.

Fact! More than half of adenogenic neoplasms are considered inoperable.

Radiation therapy for stomach cancer is prescribed 2 weeks before surgery in the absence of associated complications. The doctor selects the radiation dose according to individual indications. As a rule, irradiation is carried out 5 times a week, 2-4 Gy at a time. The total number of sessions is from 10 to 20, and the total radiation dose is 30-40 Gy. Radiation therapy may be continued after surgery.

Poorly differentiated carcinoma and its varieties are difficult to treat forms of oncology because they respond poorly to chemotherapy and radiation. Therefore, new methods are being developed to administer chemotherapy and radioactive substances directly to the cancer site. An example of this is intra-arterial polychemotherapy - the introduction of cytostatic drugs into the arteries feeding the tumor.

To increase the sensitivity of undifferentiated neoplasms to chemistry and radiation, modifying factors were invented: hyperthermia (heating of the tumor), immunotherapy, the action of magnetic fields, artificial hyperglycemia. Their use allows you to destroy a larger number of cancer cells.

Metastases and relapse of adenogenic gastric cancer

A poorly differentiated tumor is formed from the epithelium of the gastric mucosa, penetrating deeply into its layers and forming loose clusters. The neoplasm quickly spreads from the stomach tissue to the surrounding tissues and neighboring organs. This process is called implantation metastasis.

Interesting fact! 50% of patients with this type of oncology experience a relapse of the disease, and metastases in gastric cancer are detected already in the first stages of the disease in 75% of patients.

In addition, tumor cells can enter lymphatic or blood vessels, spreading through them to different parts of the body. In gastric cancer, lymphatic metastasis occurs very quickly. More often than others, secondary lesions form in the liver, regional lymph nodes, spleen, pancreas, and intestines. Also, most patients have peritoneal carcinomatosis. The undifferentiated type is characterized by early relapse (within the first three years after surgery) and was diagnosed in 90% of all cases.

When cancer develops in the gastric stump, it is subjected to extirpation, and then esophagojejunostomy is established. Treatment may also be supplemented with radiation and chemotherapy.

Metastases in distant organs are removed only in the case of well-demarcated tumors and in good health of the patient, which is very rare in adenogenic cancer.

Life prognosis for adenogenic stomach cancer

The prognosis for undifferentiated forms of cancer is considered unfavorable due to its aggressive course. It responds well to treatment only at an early stage, therefore, in order to increase the chance of recovery, timely detection of the tumor is necessary, and this requires the patient to have a certain self-organization and a responsible attitude towards health.

The average 5-year survival rate after radical treatment does not exceed 20%. Life expectancy after relapse is extremely low and averages three months.

The prognosis for stage 4 undifferentiated gastric cancer is very poor. Only a few live up to 5 years, and life expectancy often does not exceed 1 year.

How does the disease progress?

Doctors note that stage 4 stomach cancer is one of the most dangerous diseases. This is due to the fact that many cancers, including those localized in the stomach area, are almost impossible to detect in the initial stage. This is due to the fact that it does not have any typical symptoms.

There are four stages of cancer development in total. It is noteworthy that the transition of the disease to a severe stage can occur within 2 to 6 months. Doctors also note that stage 4 cancer penetrates deeply into the walls of the stomach, affecting the pancreas, blood vessels, peritoneum, ovaries and even the lung cavity. Cancer of this grade is usually detected in 80% of patients, but only 6% of patients manage to live for about 5 years.