Diagnostika

Vyšetření

Lab

• CBC
• Anemia
• Bleeding
• Liver dysfunction
• Poor nutrition
• Cca 30% of patients have anemia [2]
• Electrolyte panels
• Liver function tests
• Tumor markers
• CEA
• Vyšší in 45-50% of cases [2]
• CA 19-9
• Elevated cca in 20% of cases [2]

Esophagogastroduodenoscopy (EGD)

• Evaluate gastric wall and lymph node involvement [2]

Double-contrast upper GI series and barium swallows

• May be helpful in delineating the extent of disease
• When obstructive symptoms are present
• When bulky proximal tumors prevent passage of the endoscope to examine the stomach distal to an obstruction [2]

Chest radiography

• Evaluate for metastatic lesions [2]

CT scanning or MRI

• Of the chest, abdomen, and pelvis
• Assess the local disease process
• Evaluate potential areas of spread [2]

Endoscopic ultrasonography (EUS)

• Staging tool for more precise preoperative assessment of the tumor stage [2]

Biopsy

• Of any ulcerated lesion should include at least six specimens taken from around the lesion
• Because of variable malignant transformation
• Endoscopic ultrasonography
• Assessing depth of penetration
• Involvement of adjacent structures [2]

• Histologically:
• Adenocarcinoma - 90-95%
• Lymphomas - 1-5%
• Gastrointestinal stromal tumors (formerly classified as either leiomyomas or leiomyosarcomas) - 2%
• Carcinoids - 1%
• Adenoacanthomas - 1%
• Squamous cell carcinomas - 1% [2]