gastrointestinal disorders
Stomach Cancer
Diagnosis of Stomach Cancer
Endoscopy with biopsy Then CT and endoscopic ultrasonography of stomach cancer commonly includes Complications . Patients suspected of having stomach cancer should have endoscopy with multiple biopsies and brush cytology. Occasionally, a biopsy limited to the mucosa misses tumor tissue in the submucosa. X-rays, particularly double-contrast barium studies, may show lesions but rarely obviate the need for subsequent endoscopy. Patients in whom cancer is identified require CT of the chest and abdomen to determine extent of tumor spread. If CT is negative for metastasis, endoscopic ultrasonography should be done to determine the depth of the tumor and regional lymph node involvement. Findings guide therapy and help determine prognosis. Basic blood tests, including complete blood count, electrolytes, and liver tests, should be done to assess anemia, hydration, general condition, and possible liver metastases. The carcinoembryonic antigen (CEA) level should be measured before and after surgery. Screening with endoscopy is used in high-risk populations (eg, Japanese) but is not recommended in the United States. Follow-up screening for recurrence in treated patients consists of endoscopy and CT of the chest, abdomen, and pelvis. 