[Classification of stomach adenocarcinomas].

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.