To differential diagnosis of esophageal cancer and other diseases with the similar clinical symptoms, by using traditional X-ray study

The principal purpose of the paper is to assess the role of the X-ray section of current radiation diagnosis in obtaining objective information and interpreting it in esophageal cancer. The study was methodically based on its serial studies, by comparing the data of clinical, radiation, and endoscopic diagnosis with those of morphological studies of the biopsy specimens taken at resection for cancer of the esophagus and the upper stomach, and histologically examined them in diseases running with the similar clinical symptoms. The complex of radiation techniques included traditional X-ray study (compact filling, double contrasting). A specially developed procedure that allowed physicians the opportunity to examine the cardioesophageal area in the fragmentary fashion was used during morphological studies. In cancer of the upper stomach, the lower esophageal segments were also involved in the process in 79.9%. It should be also noted that this number of observations includes some cases that clinical symptomatology and endoscopy strongly suggest cancer of the lower third of the esophagus. The authors have arrived at the conclusion that the present-day X-ray semiotics of esophageal diseases running with the similar clinical symptomatology permits their differential diagnosis just before the use of endoscopy and histology of biopsy specimens and that the unique advantage of radiation diagnosis over endoscopy is to specify the initial site of a tumor, namely, to detect primary gastric damage in cardioesophageal carcinoma.     

Magnetic resonance imaging in the diagnosis of gastric cancer: X-ray versus MRI anatomic findings

The paper assesses the present-day role of MRI in the diagnosis of gastric cancer. The authors consider the major prerequisites for the main aim of their study to be: 1) a dramatic incidence of diffuse (endophytic) gastric carcinoma, which requires significant correction of today's approaches to its diagnosis and 2) a rather biased and, in the authors' opinion, present-day mainly negative attitude towards MRI of the stomach as a diagnostic method for its tumor lesions. By applying the X-ray-MRI anatomic principle to the comparative study of MRI findings in 50 patients with predominantly gastric intramural carcinoma and in 25 patients without gastric tumors (controls), the authors present their methods for gastric MRI, the MRI semiotics of gastric cancer by concurrently touching upon a variety of problems that characterize the potentialities of MRI of the stomach in the diagnosis of its tumor lesions, including their differential diagnosis. As a result, the authors highly appreciate gastric MRI and consider this method to be included into the diagnostic algorithm of radiation techniques used in the diagnosis of gastric cancer, which should occupy its definite diagnostic place.     

Cancer of the upper stomach: current problems of its diagnosis

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.     

Current X-ray diagnosis of stomach cancer (comparison of radiologic and morphological methods of investigation)

By using the principles of wide comparisons of the data of radiation diagnosis (routine X-ray study, ultrasonography (USG), CT, MRI) with the morphological findings of resected gastric specimens from patients with endophytic gastric cancer (EGC) (n = 85), the authors propose some points in the problem associated with its diagnosis. They believe that by taking into account the fact that there is an obvious growth of endophytic parietally growing gastric cancer with the concurrent reduction in its intestinal forms, it is necessary to restore current radiation to its leading place, along with endoscopy, in detecting the cancer. The authors makes a highly positive assessment of USG, CT, MRI in addition to routine X-ray study and endoscopy particularly in those cases when difficulties emerge in histological verification of the existing signs of parietally growing cancer. The paper makes indications for USG, CT, MRI concrete. The authors also show how to stage gastric cancer.     

Role of digital X-ray study in the current diagnosis of gastric cancer

The authors attempted to assess and provide evidence for the expedience of using a digital radiography CR system in clinical gastroenterology. The prerequisite for this was the results of large-scale diagnostic studies of different organ and systemic diseases. The authors underline the specific features of application of this digital system: the latter allows several analogue X-ray apparatuses to be transformed to digital ones, provides economic efficiency as compared with apparatuses with the direct digitization of an image, shows telemedical prospects, and has low radiation loads as evidenced by research and experimental studies even in comparison with green systems, which makes the use of these digital systems in X-ray gastroenterology highly tempting. Based on a great body of data from 126 studies, the authors could show the effectiveness of the digital radiography CR system in the diagnosis of gastric cancer, demonstrate a modernized approach to formatting an obtained digital image, the possibility of postprocessor treatment that can enhance the validity of existing X-ray symptoms. This all permitted the authors to recommend using the CR systems in the diagnosis of gastric cancer, by taking into account the current obvious predominance of its morphological diffuse and mixed forms and corresponding difficulties of their endoscopic diagnosis.     

Radiation diagnosis of tumors at four sites (the lung, breast, stomach, and large bowel) in the organizational and methodological standpoints of practical public health of the Russian Federation

The basic idea of the paper is to put forth today's vision of detecting tumors at four sites (cancer of the lung, breast, stomach, and large bowel) at the level of municipal and regional public health systems. Based on their many years' experience in "contacting" this pathology, the authors characterize the role and significance of basic radiation techniques applied to each of these four tumors, which should be used in their diagnosis. The authors also underline the need for reasonably certifying radiation diagnostic apparatuses for municipal and regional public health systems, which would efficiently combine their diagnostic and economic profitability, which will be able to avoid materializing the potential of expensive radiation equipment by just 15-20% of its built-in efficiency. By taking into account the present epidemiological situation with each of the tumors in question and scientific-and-technological achievements of current diagnostic equipment, the authors underline the need for correcting diagnostic approaches applied in their detection. The paper also presents the opinion of the authors as to selective screening. They are sure that it is impossible without its use to gain even some moderate improvement of the results of diagnosis and hence those of treatment of tumors at four sites, which are all responsible for 50% of all malignancy. The idea that it is necessary to actively return radiation studies to the diagnosis of cancer of the lung, breast, stomach, and large bowel runs throughout the paper. As applied to tumors at each of these sites, the authors express their opinion as to their radiation diagnosis. Naturally, they could not ignore the fact that the authorities of medical industry in our country should take an active part in the solution of organizational problems touched upon in the paper.     

Potential use of radiation diagnosis of esophageal achalasia

The prime objective of the paper is to attempt to reevaluate the potentialities of current radiation diagnosis of esophageal achalasia. Moreover, its main idea is to assess the procedure of a traditional X-ray section of radiation study. In the authors' opinion, the main motivation of writing this paper was the emergence of new recent potentialities of radiation diagnosis, including its traditional X-ray section in gastroenterological pathology, as well as a considerable body of information on esophageal achalasia (144 cases). The tasks to be solved in the paper include the differential diagnosis of esophageal achalasia and cardioesophageal cancer, as well as the basic capacities of radiation diagnosis to help clinicians in characterizing the changes caused by medical and surgical treatments for this disease. The authors consider that the obtained volume of necessary information on this abnormality rather frequently encountered in esophagogastroenterological pathology can be increased by applying the current possibilities of radiation study and mainly its traditional X-ray section.     

Possibilities of radiologic methods (ultrasonography, computed tomography) in the preoperative evaluation of intramural invasion of gastric cancer

By analyzing the findings in 72 patients with gastric cancer, the authors show the potentialities of noninvasive techniques of radiation diagnosis (transabdominal ultrasonography (USG) and X-ray computed tomography (CT) in the preoperative evaluation of the T-stage of gastric cancer. Ultrasound and computed tomographic semiotics of intramural invasion of gastric carcinoma is made. Ultrasonography was found to have the highest specificity in detecting early-stage gastric cancers prior to computed tomography. In the authors' opinion, a complex use of the data obtained by these techniques reveals the degree of invasion of gastric carcinoma and its extent with high precision. Transabdominal USG and CT should rank with the initial methods used for diagnosing gastric cancer. Transabdominal USG should be most expediently used as an initial technique of the above studies, by taking into account its wide accessibility, easiness-to-use, and lack of radiation load.     

The MUC gene family: their role in the diagnosis and prognosis of gastric cancer

Early diagnosis of gastric cancer and its differential diagnosis from other non-malignant gastric diseases like gastritis is still a major clinical problem. Most patients are asymptomatic in the early stages of gastric cancer, and there is no reliable marker available for the early and specific diagnosis of gastric cancer. Many attempts have been made to define the biological profile of gastric cancer to improve the chances of its early diagnosis, prognosis and treatment. Several studies have shown the aberrant expression profile of mucins in different malignancies, suggesting that mucins have a great potential to be used as a diagnostic and prognostic marker in gastric cancer. In this review, we have briefly described the different types of gastric adenocarcinomas and the progression of gastric cancer. Furthermore, the role of mucins and their related carbohydrate epitope is discussed in the normal stomach and in the diagnosis and prognosis of gastric adenocarcinomas.     

Gastric magnetic resonance study (methods,semiotics)

The paper shows the potentialities of gastric study by magnetic resonance imaging (MRI). The methodic aspects of gastric study have been worked out. The MRI-semiotics of the unchanged and tumor-affected wall of the stomach and techniques in examining patients with gastric cancer of various sites are described. Using the developed procedure, MRI was performed in 199 patients, including 154 patients with gastric pathology and 45 control individuals who had no altered gastric wall. Great emphasis is placed on the role of MRI in the diagnosis of endophytic (diffuse) gastric cancer that is of priority value in its morphological structure. MRI was found to play a role in the diagnosis of the spread of a tumorous process both along the walls of the stomach and to its adjacent anatomic structures.     

A place of outpatient screening in the formation of a current organizational scheme for better radical detection of breast cancer

The authors consider it necessary to revise the current views of breast cancer in women. In their opinion, excessive consideration of mammography as an independent section of radiation diagnosis does not contribute to better detection of breast cancer. The principle of including mammography into the general traditional section of current radiation diagnosis should be regarded as of paramount importance. Mammography should be widely introduced into the general polyclinic network of the practical health care system of the Russian Federation. The so-called mammological dispensaries (centers) that have been or being set up should more clearly define their functions mainly to rendering an organizational and methodological assistance in the diagnosis of breast cancer at a routine outpatient level, to make its specified diagnosis, and to define the tactics of rendering a medical care of detected breast pathology in the polyclinic. The authors consider that the wide introduction of screening for breast cancer into the practice of polyclincs is one of the basic ways of improving of its detection.     

Potentialities of ultrasound study in diagnosis of endophytic carcinoma of stomach

The data of studies of 45 patients with gastric cancer are used to consider the potentialities of ultrasonography (USG) in the diagnosis of its endophytic forms. Its use in the diagnosis of "small" gastric carcinomas is evaluated. The USG semiotics of endophytic tumors of the stomach, including its "small" and early forms, is presented. The place of USG in the diagnostic algorithmic of gastric cancer is specified. In the authors' opinion, gastric USG along with traditional X-ray and endoscopic studies should take an appropriate place as it is beneficial in solving a great deal of differential diagnostic problems associated with the intramural spread of tumors.     

Some problems of radiation diagnosis of colon cancer

The paper gives the view of the author who is based on his many-year experience in studying a role of radiation diagnosis of colon cancer. It shows it necessary to enhance the significance of radiation diagnosis. More attention should be given to the traditional section on the current radiation study of the large bowel: to irrigoscopy and single double contrasting. By taking into account the labor-consumption of irrigoscopy, the author suggests that the procedure should be simplified without losing its diagnostic capacities. However, he considers single double contrasting of the bowel to be the optimum technique of traditional X-ray study of the bowel in detecting its tumors. Pneumocolonoscopy and iliocecal node study of the ileocecal angle are given in the paper as supplementary techniques of traditional X-ray study of the large bowel. Emphasis is also placed on the role of radiation diagnostic techniques, such as ultrasound diagnosis, X-ray computed tomography, and magnetic resonance imaging. By highly appreciating their significance in the diagnosis of colon cancer, the author believes that they should play a role of important, but additional ways of detecting this pathology. By pointing out the excellent capacities of fibrocolonoscopy, as applied to the problem discussed in the paper, the author does emphasize the certain limitations of this technique, by taking into account that its application can cause some complications. The author's opinion that the obvious increase in the incidence of endophytic carcinomas drastically enhances the role of their radiation diagnosis, but by obligatorily correcting currently available principal methodic and semiotic directives, runs through the entire paper.     

Use of CR in the detection of present gastric cancer: diagnostic aspects

The authors describe the state-of-the-art of gastric cancer detection in detail and show the current principles of its radiodiagnosis. They provide a detailed explanation for that radiodiagnosis should be urgently returned into gastroenterology as an equal with endoscopy, which is based on the existing tendency for the major morphological types of gastric cancer to appear. The present-day capacities of radiodiagnosis of gastric cancer are mainly based on the introduction of the digital technologies into traditional radiology, which will replace the analog imaging principle in the foreseeable future. The authors present their data of examining 300 gastric cancer cases diagnosed by the CR system and later verified by a morphological study of resected gastric specimens. They emphasize that intraparietally growing gastric cancer is frequently inaccessible for endoscopy long, which determines the need for two basic procedures (radiodiagnosis and endoscopy) coexisting on a par for the detection of gastric cancer. They are sure that computed radiology (CR) will be the most acceptable way of changing traditional radiology to the digital imaging principle in primary, municipal health care in the near future.     

Current possibilities of X-ray diagnosis of small intestine diseases using the agent Entero-view

The paper analyzes the current capacities of routine (classical) X-ray study in the diagnosis of organ diseases of the small bowel. The distinctive feature of the paper is that in addition to routine barium passage through the small bowel, the new barium contrast agent Entero-view specially designed for its exploration is used. Of the 115 examined patients with various gastroenterological diseases, 76 underwent Entero-view examination that revealed different organ pathology of the small bowel in 28 cases (Crohn's disease in 18, tuberculosis in 3, lymphomas in 5, and cancer in 2). A normal X-ray pattern of the small bowel was diagnosed in 48 cases. The authors highly appreciate this agent. In their opinion, it is essentially helpful in solving one of the most difficult problems in X-ray gastroenterology--present-day X-ray diagnosis of small bowel pathology. The paper describes a procedure for using this agent. It gives a normal X-ray pattern of the small bowel, the agent's use has provided a particularly vivid image of both a normal part of the ileum and its different organ pathology-associated changes.     

Place of digital X-ray fluorography in improving the diagnosis of pulmonary tuberculosis,lung cancer and mediastinal pathology

The prime objective of this paper is an effort to make a comprehensive assessment of a place of current digital X-ray fluorography in the diagnosis of various diseases of the lung, primarily its tuberculosis and cancer, and abnormalities of the mediastinum. The investigation used a principle of obligatory examination of the diagnostic potentialities of film X-ray study and digital X-ray fluorographic findings. Assessment of digital X-ray fluorography showed its potentialities of identifying an abnormality just on the monitor screen and through printer (paper) image reproduction. A total of 2,500 cases from different patient groups (those registered at a dispensary or identified at screening, those with a previously verified pathology). In addition to a particularly diagnostic section, the authors state their ideas on a multiplicity of organizational and methodological problems in the introduction of digital X-ray fluorography into practical public health of Russia. By defining "a diagnostic field" of application of the method, the authors restrict it only to the diagnosis of lung and mediastinal diseases.     

Capacities of ultrasound study in the diagnosis of diffuse gastric carcinoma

By using 237 verified cases of diffuse carcinoma and benign diseases of the stomach as an example, the authors assess the capacities of routine transabdominal ultrasound study (USS) of the stomach in the diagnosis of tumors and present their modification of the procedure facilitating the imaging of problem areas. In the authors' opinion, the symptoms of thickening of the wall of the stomach and abnormalities in its normal five-layered structure indicate diffuse gastric carcinoma. The authors consider USS to be a supplement to the basic diagnostic techniques--X-ray study and gastroscopy.     

Computed tomography in the diagnosis of endophytic cancer of the stomach

The authors discuss the potentialities of CT in the diagnosis of endophytic stomach cancer. They proposed a method for CT of the stomach based on a pneumatic study of its lumen via a nasogastric probe with graded inflation and repeated CT imaging. The major CT-semiotics of endophytic stomach cancer were obtained. This method should be employed in combination with the existing routine methods of stomach cancer diagnosis, and its efficacy is in direct relation to the quality of preliminary routine x-ray and endoscopic investigations.     

Fast detection of phosphorylation of human pepsinogen A, human pepsinogen C and swine pepsinogen using a combination of reversed-phase high-performance liquid chromatography and capillary zone electrophoresis for peptide mapping

A combination of reversed-phase high-performance liquid chromatography (RP-HPLC) and capillary zone electrophoresis (CZE) was used for characterization of α-chymotryptic digests of human pepsinogen A, human pepsinogen C (both isolated from stomach mucosa of patients suffering from gastric cancer), swine pepsinogen and their dephosphorylated forms. Combining RP-HPLC and CZE for peptide mapping allowed to detect phosphorylations in molecules of the above mentioned gastric zymogens. We have found one phosphate group in the molecule of human pepsinogen A and two phosphate groups in the molecule of human pepsinogen C. The investigated sample was obtained from stomach mucosa of a patient suffering from gastric cancer. An increased number of phosphate groups in molecules of human pepsinogen seems to be associated with gastric cancer. The developed method represent a suitable tool for studying relationships between specific phosphorylations of proteins and cancerogenesis or potentially could serve for early diagnosis of gastric cancer.     

Environment and cancer in Brazil: an overview from a public health perspective

This paper presents the current pattern of cancer incidence in Brazil by analyzing the country's cancer epidemiological profile. The authors highlight the observed overlapping distribution of cancer incidence in Brazil in tumor sites normally associated with higher socioeconomic status (cancers of the breast, prostate, and colon/rectum, among others) and poverty (cervix, stomach, oral cavity, and penis). In addition to analyzing the demographic and social characteristics associated with current epidemiological distribution of cancer in Brazil, the authors present several of the most important environmental risk factors (smoking and exposure to radiation, pesticides, and other chemicals) and discuss their respective exposure levels in the Brazilian context.The article concludes with an evaluation of the principal challenges facing environmental cancer control programs in Brazil, particularly focusing on smoking and exposure to chemicals.