CLASIFICACIÓN DE LOS
ADENOCARCINOMAS DE ESTÓMAGO
Hernán Espejo Romero *, Jesús Navarrete Siancas**
SUMMARY
Malignant stomach tumors include carcinomas, lymphomas, leimiosarcomas, carcinoids and
other less frequent tumors. Adenocarcinoma has been classified in many different ways and
by many different authors. Depending on its stage, early or advanced, on one side and
according to the TNM staging system (Tumor, Nodes, Metastases) on the other. The
early-stage adenocarcinoma, from the macroscopic point of view has been classified in I,
IIa, IIc, IIb and III and combinations therefrom. Early-stage cancer has been denominated
as O type and advanced cancer, which has been denominated by common practice, as Borrmann:
I, II, III and IV, is now numbered using Arabic numbers 1, 2, 3 and 4. Type 5 is included,
which would correspond to the non-classifiable carcinoma. Histologic classification
according to Lauren, comprises intestinal, diffuse and the mixed or undifferentiated type
which produces no mucus. According to Mulligan, it is classified as: pyloric glands and
intestinal type cancer on one side and gastric type cell cancer on the other side.
The WHO (World Health Organization) classifies them as: Papillary, tubular (tub.1, tub.2
and tub.3) signet ring cell, undifferentiated and mucinous adenocarcinoma.
Nakamura, Kato and Hirota classify them as: differentiated and undifferentiated
adenocarcinomas. Ming classifies them as: expanding type and infiltrating type.
There is a tendency, when dealing with early-stage cancer, to group its forms in
ulcerating carcinomas, vegetating carcinomas, localized gastritis-like and advanced-like
carcinomas. The gastritis-like classification would correspond to form IIb of the initial
classification of early-stage cancer. Broders' classification of Adenocarcinoma grade 1,
2, 3 and 4 is mentioned here as a classification solely on basis of the cellular
differentiation. As historical classification, we include that of James Ewing.
The above mentioned classifications relate to each other and are not excluding from the
conceptual point of view.
KEY WORD: Gastric adenocarcinoma.
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