Cardia cancer (benmenai) is an adenocarcinoma that occurs in the cardia of the stomach, which is about 2 cm below the esophagogastric junction line. It is a special type of gastric cancer, but different from other parts of the stomach, with its own anatomical-histological characteristics and clinical manifestations, unique diagnostic and therapeutic methods and poorer surgical outcomes. In China, the mortality rate and incidence rate of pancreatic cancer rank the highest among all types of malignant tumors. Some data show that the mortality rate of pancreatic cancer accounts for about 12% of the total mortality rate.
The differential diagnosis of cardia cancer includes cardia spasm (cardia achalasia), stenosis caused by chronic inflammation of the lower esophagus, and peptic ulcer in the cardia.
1, cardia spasm: clinical features are young, long medical history, long history of dysphagia, but still maintain moderate health. x-ray esophagogram shows symmetrical smooth funnel-shaped stenosis above the cardia and its highly dilated proximal segment of the esophagus.
2, lower segment esophagitis: often accompanied by hiatal hernia and gastric reflux, the patient has a long history of heartburn and acid reflux, short and fat, inflammation for a long time triggered by scar stenosis, swallowing disorders. barium X-ray meal shows lower segment esophageal cardia stenosis, mucosa can be irregular, esophagoscopy sees inflammatory granulation and scar, sometimes not easily distinguished from cancer. Repeated multi-point biopsies can confirm the diagnosis if the results are always negative.
3.Vinous varices in lower esophagus and gastric fundus: tumor type varices can resemble cancer on x-ray, especially squamous carcinoma can spread upward and downward along the esophagus showing polyp-like negative shadow of different sizes, which resembles twisted mucosa of varices when examined by thousand x-ray. Therefore, it should be differentiated based on clinical history, hepatosplenomegaly and short-term barium meal imaging review, etc. If necessary, esophagoscopy can be performed to confirm the final diagnosis.
4. Pancreatic tumor: Because of the anatomical location of the pancreas, especially the tail of the pancreas, which is lateral to the fundus of the stomach. Therefore, pancreatic tail tumor can often invade the lower end of the esophagus, cardia, and even infiltrate into the gastric fundus.
5.Esophageal hiatal hernia: The mucosal widening and disorder at the cardia of gastric fundus due to herniation of gastric mucosa into esophagus often causes difficulties in identification during x-ray examination, and sometimes some patients with esophageal hiatal hernia can be combined with carcinoma.