[Gastric cancer: diagnostic problems]

Gastric cancer is still one of the most prevalent cancer diseases. Despite a more than 30-year priority use of endoscopy in the diagnosis of gastric cancer, this condition is still virtually impossible to be detected at early stages. Many-year experience gained by the authors permitted them formulate two causes of this rather poor state of the art: 1) no screening programs for the early detection of gastric cancer and 2) under-valuation of the frequency of endophytic (infiltrative) forms of gastric tumors and of potentialities of modern x-ray examination in the diagnosis thereof. According to their results, gastric cancer was diagnosed in 539 cases out of more than 40,000 screenings. Analysis of more than 2,000 common clinical cases of gastric cancer brought the authors to a conclusion that endophytic, infiltrative (intraparietal) form of malignant tumor growth is the major form. A new sign of initial manifestations of intraparietal gastric cancer is suggested: intraparietal blastomatous infiltration symptom. The authors emphasize that roentgenology should again become the principal method in the diagnosis of gastric cancer. Only combined use of roentgenology and endoscopy may appreciably improve the detection rate of this grave disease.