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Clinico-pathological presentation of gastric carcinoma and its relation to the anatomical site of occurrence among patients in the hilly state of Himachal Pradesh, India

Background: The incidence of gastric cancer varies in different parts of the world and among various ethnic groups. Himachal Pradesh, located in the north of India, has different customs, food habits, life-style and diverse ethnic groups. We undertook this study to analyze the clinical presentations and pathological characteristics of stomach cancer patients in the biggest referral center in the state.Methods: All endoscopic biopsy proven cases of carcinoma stomach attending the OPD or admitted in the general surgery ward between July 2014 to June 2015, went through a thorough clinical examination, routine and diagnostic investigations and endoscopic biopsies for histopathological confirmation.Results: The study included 62 patients of adenocarcinoma stomach with maximum cases between 45 to 65 yrs age, more in males (2:1). Borrmann type II was most common macrocsopic appearance followed by type IV. As per Lauren classification, 36 were of intestinal, 24 diffuse and 2 had mixed type. 10 patients had well differentiated, 28 moderately differentiated and 24 patients had poorly differentiated tumors. Anorexia, abdominal pain, weight loss, nausea and vomiting was the most common symptoms seen in antral lesions (distal) and anemia was the most common sign followed by dehydration, mass abdomen and ascitis.Conclusions: The study has added to the literature of clinical and pathological presentation and relation of signs and symptoms to the site of occurrence of gastric carcinoma from the hilly and rural state of northern India. 