Types, forms and classification of stomach cancer

Recently, worldwide experts have noted an increase in reported cases of stomach cancer. The classification of this ailment will be described in our article. Today, this type of cancer has a high mortality rate, second only to lung cancer. It is characterized by the rapid growth of the epithelium of the mucous membranes with the active spread and progression of metastases. The disease diagnosed in time, as well as the location of the tumor, is most often detected in the antrum, however, there are cases when it forms in the cardinal or pyloric departments. Let's take a closer look at the varieties and classification of stomach cancer.

Varieties

For convenience, this disease is usually classified into some groups. The classification of gastric cancer is carried out according to three main criteria, which should include:

1. Form.
2. Cancer growth.
3. The histological type.

Two forms of cancerous growths determine their growth. Considering the classification of gastric cancer, these forms of tumors should be identified:

1. An intestinal form located in the cavity of the stomach, and neoplasm cells are interconnected. This form is characterized by the least aggressiveness.
2. The diffuse form, during which the formation into the cavity does not grow, but increases through the thickness of the walls of the stomach. There is no connection between the cells.

Histological classification

You should also pay attention to the fact that the histological type of tumor cells is divided into several subspecies:

1. Glandular neoplasm arising from the transformation of gland cells.
2. Squamous cell growth, in which epithelial cells are reborn under the influence of negative factors.
3. Adenocarcinoma, during which the emergence of a new formation is associated with the degeneration of secretory cells of the gastric mucosa into cancerous.
4. Cricoid-cell form, developing from goblet cells.
5. Undifferentiated form, which is characterized by rapid progression. It is characterized by severe malignancy. A tumor is formed from immature cells belonging to the mucous membrane.

In shape

Above, we examined the histological classification of gastric cancer. However, this disease is usually divided in form. These include:

1. Infiltrative form. These include diffuse and ulcerative infiltrative forms of the disease.
2. Transitional. This group includes colloidal and fibrous cancer.
3. Limited. It is divided into polypoid, flat and mushroom-shaped cancer.

Variety metastasis

If the patient has been diagnosed with gastric cancer, the rate of metastasis will depend on several factors. One of the main in this case is the state of the human immune system, that is, its ability to resist the disease. Another important factor is the localization of the neoplasm. It will depend on the location in which systems and organs metastases can penetrate. The histological structure of the tumor also significantly affects the size. The spread of metastases in the human body is carried out in one of three types:

1. Lymphogenic type of metastasis.
2. Hematogenous type of metastasis.
3. Implantation type of metastasis.

Hematogenous type

The defeat of metastases, which belong to the hematogenous type, is characterized by the entry of cancer cells into healthy organs using the portal vein. This type of metastasis in most cases affects the liver. As for secondary neoplasms, in addition to the liver, they can also form in the bones, lungs, and also in the pancreas.

Lymphogenic type

As for the lymphogenous type, cancer cells form in the lymph nodes, along the gastric arteries, as well as in the splenic artery and nodes of the second lymph flow. In addition, the lymphogenous type of metastasis is divided into several subspecies:

1. The defeat of the lymph nodes on the left in the clavicle. Such metastases are called Virhwa metastases or Virchow nodes.
2. Detection of cancerous tumors in the pararectal lymph nodes. These metastases are commonly called Schnitzler metastases.
3. The entry of malignant cells into the lymph nodes located in the armpit area. These metastases are commonly called Irish metastases.
4. Kruckenberg ovarian cancer.
5. Metastases called Joseph metastases can be found in the umbilicus and the roundabout of the round connection of the liver.

Implant type

If we consider separately the implantation type of stomach oncology, then it is often called contact in medicine. In this case, metastases begin to germinate in neighboring organs, for example, in the pancreas, esophagus, liver, gall bladder or spleen. There should also be attributed carcinomatosis. By this term is meant the presence of malignant cells in the pleura and diaphragm.

Bormann classification

It should be noted that there is also a Bormann classification for stomach cancer. This classification includes four varieties:

1. A neoplasm in the form of a mushroom, which is clearly limited from healthy tissue of the stomach. Attaches on a wide base to the mucosa. But may also have a thin leg. It is because of this that education got its name. The tumor progresses slowly, metastases are very rare. It lends itself very well to therapy, in almost all cases it is worth counting on a positive prognosis.
2. Severe carcinoma. A characteristic feature of this type of stomach cancer is the shape of a saucer with a small indentation in the middle, as well as with raised edges. In addition, the neoplasm has clearly defined edges. There is no visual difference with a common ulcer, therefore histological examination should be performed. Please note that this form of stomach cancer has a high percentage of the favorable course of the disease.
3. Partially expressed carcinoma. This form of neoplasm does not have clear boundaries, as well as healthy tissues. It is characterized by infiltrative germination in the deepest layers of the mucous membrane.
4. Diffuse-infiltrative carcinoma. This form of stomach cancer is a mixed subspecies. It germinates infiltratively in the submucosal layer, and also affects the main part of the stomach. During gastroscopy, it is very difficult to recognize it. The infiltrative form also does not have the most favorable prognosis. Its characteristic is rapid metastasis to neighboring organs.

Japanese classification

In medicine, there is also a Japanese classification of stomach cancer. It includes three types of disease:

1. Swelling cancer. With this type of disease, neoplasms in the form of polyps appear above the surface of the mucous membrane. The upper region is flat, but there may be a recess and a short leg.
2. Superficial cancer. According to this classification, three subspecies are also distinguished: flat, raised, depressed.
3. Ulcerative cancer. In appearance, this form of the disease is somewhat similar to an ulcer, which is pressed into the middle, and also has raised edges.

TNM classification of gastric cancer

We continue to consider various classifications of cancer of the stomach. One of these is TNM classification of gastric cancer. This type of classification is international, therefore it is most often used in diagnosing a disease.

• T is the accepted designation used for the primary tumor.
• Tx - it is impossible to identify or evaluate a tumor.
• T0 - no data, that is, a malignant tumor was not detected.
• Tis is a preinvasive carcinoma characterized by severe dysplasia.
• T1 - the initial stage of the growth of malignant tumors; in case of detection, it can be seen that neighboring healthy cells are not affected.
• T1a - tumor cells are located in the mucous membrane.
• T1b - germination in the subsequent submucosal layer of the organ.
• T2 - metastases were found in the muscle of the organ.
• T3 - oncological cells identified in the subserosal zone.
• T4 - the tumor has already spread to nearby organs, as well as the serous membrane.
• N - stage of the defeat of regional lymph nodes.
• Nx - the condition of the lymph nodes is difficult to assess due to lack of data.
• N0 - there is no damage to the lymph nodes by metastases from a cancer tumor.
• N1 - there are metastases on 1-6 lymph nodes.
• N2 - there are metastases on 7-15 lymph nodes.
• N3 - More than 16 lymph nodes have malignant cells.
• M - designation for the most distant metastases.
• M0 - there is no damage to other organs.
• M1 - metastases detected.

Localization

So, we have considered the classification of gastric cancer by stages. However, the type of cancer is determined by the location of the tumor. The neoplasm can be located absolutely in any part of the stomach. There are several, for example:

1. Distal section. The neoplasm in this department is characterized by belching and vomiting.
2. The proximal section. This type of cancer is characterized by common symptoms and dysphagia.
3. The body of the stomach. This should include anemia, weakness, as well as general intoxication of the body.
4. The back wall of the stomach. The patient has symptoms of pancreatitis, as well as metastasis to the pancreas.
5. Complete lesion of the stomach. In this situation, the patient feels severe discomfort. All the symptoms characteristic of this type of cancer, as well as its ulcer form, are manifested.

Based on the foregoing, it can be concluded that there are several types of classification of gastric cancer. Early diagnosis of this disease will allow the patient to hope for a more favorable prognosis of the course of the disease.