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Exfoliative Cytology as an Aid to the Diagnosis of Gastric Carcinoma

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Abstract

GASTRIC carcinoma is increasingly important because of the diagnostic and the therapeutic problems it raises and the high annual mortality—40,000 persons1—in this country. Because of this high mortality many surgeons advocate drastic surgical therapy for all potentially malignant lesions in the stomach. Ochsner and Blalock2 believed that all gastric ulcers should receive surgical treatment, and warned of the great responsibility assumed by the physician who institutes conservative treatment of an ulcerative gastric lesion. Ravdin3 and others are of a like opinion.

The reported five-year survival rate for all patients having carcinoma of the stomach has varied from 1 to 15 per cent.4,5 The Cleveland Clinic rate for the years 1940 through 1945 was 7.1 per cent. With the more frequent and, at times, extensive resections being performed for the past 10 years, a greater number of patients are selected for operation and the five-year survival rate should be higher.6–8 For a personal series of 53 patients with gastric carcinoma who underwent gastric resections for cure, Hoerr,9 at the Cleveland Clinic, has had a five-year survival rate of 36 per cent.

The low survival values have been thought to result, in part at least, from the difficulty of obtaining an early diagnosis. Certainly, the detection of the disease at a stage when more favorable resections can be performed is dependent upon its recognition before metastasis or marked local extension occurs. Routine screening by roentgen examination of the stomach, as done on 7,500 patients at Johns Hopkins Hospital and. . .


 

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