Open AccessEarly clinical and pathophysiological manifestations of gastric cancer at the outpatient clinic stage (The “RADIUS” study)
Author(s) -
Н. Н. Дехнич,
Л. Б. Лазебник,
А. А. Тряпышко,
Н. Д. Елистратов,
E.D. Rzhevtseva,
Н. В. Евстафьева,
М. А. Ковалерова,
О. А. Колядзина,
С. А. Ромадинова,
Е. М. Бухарина,
Н. С. Шелудько,
Anna Akhmedova
Publication year - 2020
Publication title -
èksperimentalʹnaâ i kliničeskaâ gastroènterologiâ
Language(s) - English
Resource type - Journals
ISSN - 1682-8658
DOI - 10.31146/1682-8658-ecg-179-7-62-68
Subject(s) - medicine , cancer , outpatient clinic , nausea , stage (stratigraphy) , gastroenterology , epigastric pain , leukocytosis , disease , vomiting , paleontology , biology
Objective . To study the early clinical and pathophysiological manifestations of gastric cancer in the outpatient phasefor early diagnosis disease. Methods . A total of 300 outpatient cards of patients treated in Smolensk Oncology Hospital with gastric cancer were analyzed during 2016-2019. Data collection included filling out a questionnaire consisting of 32 questions aimed at clarifying demographic data, diagnosing the symptoms of the disease and their duration, identifying the warning signs, precancerous lesion of the gastric mucosa, previous diagnosis and treatment of H. pylori . The study included patients with gastric cancer aged 31 to 88 years. The mean age of patients was 65.12±9.92 years, the median age was 65.5 years. Among 300 patients, 153 (51%) were male and 147 (49%) were female. Results . 2.7% (n=8) of diagnosed patients account for young people. 32.7% (n=98) of patients were diagnosed with the stage II cancer, 32.3% (n=97) — with the stage III cancer. The most common symptoms of the disease were epigastric pain — 57% (n=171), dysphagia — 19.3% (n=58), nausea — 15% (n=45), unmotivated weight loss — 12% (n=36) and epigastric burning — 7% (n=21). These symptoms bothered patients up to 6 months in 32.7% (n=98) of cases. Biochemical blood tests (80%, n=192/240), accelerated ESR (76%, n=183/241), decreased hemoglobin (69%, n=178/258), and leukocytosis (48%, n=120/248) were identified as the most common “warning” signs. 24.7% (n=74) of patients had atrophic gastritis preceded the development of gastric cancer, 24% (n=72) — gastric ulcer, 12% (n=36) — polyps of the stomach. The previous diagnostics of H. pylori was carried out only in 1.3% (n=4) of patients. Conclusions . If a patient, including a young patient, has epigastric pain, primary care physicians should recommend esophagogastroduodenoscopy with biopsies to determine precancerous changes in the gastric mucosa and the presence of H. pylori , followed by eradication therapy.