Carcinoma of stomach: evaluation of individual and combined diagnostic accuracy of radiology, cytology, and gastrophotography

Clinical utility of decarboxylation prothrombin combined with α-fetoprotein for diagnosing primary hepatocellular carcinoma

We conducted a comprehensive analysis to evaluate clinical utility of decarboxylation prothrombin combined with α-fetoprotein (AFP) for diagnosing primary hepatocellular carcinoma (HCC). Systematical searches were performed in PubMed, Web of Science, China National Knowledge Internet, and Wangfang databases. The bivariate random-effect model was used to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood, diagnostic odds ratio (DOR), and summary area under the curve (AUC). Fourteen studies were included in the meta-analysis. For decarboxylation prothrombin, the overall pooled parameters are as follows: sensitivity: 79% (95% confidence interval (CI): 74-84%), specificity: 91% (95%CI: 87-93%), PLR: 8.42 (95%CI: 5.79-12.23), negative likelihood ratio (NLR): 0.23 (95%CI: 0.17-0.30), DOR: 37.09 (95%CI: 21.37-64.36), summary AUC: 0.92 (95%CI: 0.89-0.94); for combined diagnostic, the overall pooled parameters were as follows: sensitivity: 91% (95%CI: 85-95%), specificity: 83% (95%CI: 74-89%), PLR: 5.26 (95%CI: 3.53-7.83), NLR: 0.11 (95%CI: 0.07-0.18), DOR: 47.14 (95%CI: 30.09-73.85), summary AUC: 0.94 (95%CI: 0.91-0.95). The serum decarboxylation prothrombin showed a relatively higher diagnostic specificity for primary HCC and decarboxylation prothrombin combined with AFP exhibited can improve sensitivity for HCC than any of the biomarkers alone.

Cytological screening for cancer of the stomach

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Diagnosis of gastric cancer

A prospective comparison was made of the accuracy of different diagnostic methods for gastric cancer. The basis of the study was a consecutive series of 113 patients thought to have gastric pathology; cancer was the final diagnosis in 32. Endoscopy and radiology were the most accurate investigations, whereas biopsy, cytology, and clinical examination gave disappointing results. A wide range of clinical features and laboratory investigations were studied in all patients in an attempt to identify criteria suggestive of malignancy. Multifactorial computer analysis of these investigations failed to improve upon the radiological diagnosis. A systemic approach designed to make optimal use of limited endoscopic and histopathological resources in the diagnosis of gastric lesions is presented.

Gastroscopy and gastric photography with the Olympus GTF-A

One hundred patients were examined with the Olympus GTF-A fibregastroscope and gastrocamera. The entire stomach was seen in most cases; the technique permitting this is described in detail. The examination was most rewarding in patients with gastric haemorrhage and when radiology was equivocal. Advantages and disadvantages of the instrument are discussed.