[The patient’s symptoms were often weakness and dizziness, but he did not pay attention to them because he was nervous at work and did not go to the hospital for examination until he had obvious symptoms such as epigastric distension, nausea and vomiting. Gastroscopic examination revealed a huge ulcer in the sinus of the stomach, which was considered to be malignant, so he was admitted to the hospital for surgery. During the operation, it was found that the giant tumor in the gastric sinus was 10 cm in diameter, with extensive infiltration of liver, bile, pancreas and blood vessels, and extensive metastasis in the abdominal cavity. There were hundreds of metastatic nodules in the greater omentum, large ones like walnuts and small ones like sesame seeds, and the tumor could not be removed. Some of the specimens were taken for pathological examination during the operation, which indicated that the tumor was a hypofractionated adenocarcinoma of the stomach (with high malignancy). This young white-collar worker was diagnosed too late and the tumor metastasized extensively, so he lost the chance of radical surgery. [A young man of 18 years old in Jiangxi always had pale skin and dizziness, and his father always bought him some iron supplements at first, but he never got well. A year later, he went to the local hospital, but the local doctor didn’t take it seriously and didn’t do any systemic examination, and continued to treat him with iron deficiency anemia. It was only after the discovery of liver occupancy and ascites that the primary disease was found to be gastric cancer, but it was too late. In recent years, although the incidence rate of gastric cancer has been decreasing year by year, from the first place in the 1970s to the third place in the 1990s, there is a trend that the incidence group is getting younger and younger. The so-called young people with gastric cancer refer to those who are less than 30 years old. One of the statistics is alarming, foreign literature reports that gastric cancer patients younger than 30 years old account for 2.01% of the total number of gastrointestinal cancer patients, while the data in China is as high as 7.6%. Characteristics of gastric cancer in young people 1. There are few early cases of gastric cancer, which are divided into four stages, stage I and II are early stage with good treatment effect; stage III and IV are middle and late stage cases with very poor treatment effect. But sadly, among young people diagnosed with gastric cancer, stage III or IV patients account for 60% to 85%, while almost all patients under 20 years old are stage III or IV. Some studies have shown that there is no significant difference between stage I and II gastric cancer surgical treatment in young and old people, and they are both types with good efficacy, and the 5-year survival rate after surgery can reach 85%. On the other hand, advanced gastric cancer (stage III and IV) has poor surgical treatment effect, and is prone to metastasis and recurrence after surgery, with a 5-year survival rate of only 20%, which shows the importance of early diagnosis. It is well known that the higher the malignancy of a tumor, the worse the treatment effect. Among the diagnosed gastric cancer in young people, the most poorly differentiated mucinous adenocarcinoma accounts for 50% to 60%, which is 3 to 6 times more than that of elderly patients; patients younger than 20 years old actually account for 80% to 90%. 3. Vomiting is a prominent symptom and easy to bleed. Since patients are mostly in advanced stage when they are seen, they are prone to pyloric obstruction, so about 40% of patients have vomiting as the first manifestation. As for bleeding, most of the patients will not pay attention to it and will be treated as iron deficiency anemia for a long time, which will cause delay. Among young female gastric cancer patients, the rate of ovarian metastasis is as high as 14%, and 1/3 of the patients come to the hospital with ovarian tumor, and some even wait until ovarian tumor surgery before showing metastasis. In some cases, the metastatic adenocarcinoma was not revealed until after the ovarian tumor surgery. On the one hand, this shows that the medical personnel do not know enough about this kind of disease, and on the other hand, it also reflects the high malignancy of the tumor. 5.Long diagnosis time and high misdiagnosis rate Generally, it takes 5 to 15 months for young people with gastric cancer to be diagnosed from the time they have discomfort to the hospital, and the misdiagnosis rate of young people with gastric cancer is as high as 68.3%. Patients are often diagnosed with gastritis, cholecystitis, intestinal worms and iron-deficiency anemia at the early stage. There are many factors leading to misdiagnosis, which can be summarized into the following three points: (1) patients do not pay attention to them, always thinking that they are young and will not have any big problems, plus they are busy with work and study, so they neglect their own health condition; (2) parents do not have relevant knowledge, and most of them think that their children’s symptoms such as anemia and abdominal pain are “minor problems” based on their own experience. (2) parents do not have the relevant knowledge, most parents think that their children’s anemia, abdominal pain and other symptoms are “minor” based on their own experience, and casually buy some medicine, and only when the condition is very serious, they come to the hospital, but it is too late; (3) the subjective assumptions of doctors. Many doctors use some symptomatic drugs based on experience when they see young patients, and they do not even bother to do abdominal physical examination or remind patients to do gastroscopy, and only when metastatic lesions or pyloric obstruction are found, they remember to look for the primary lesion, which directly delays the diagnosis of the disease. 6.Poor prognosis Due to late diagnosis and high malignancy of tumor, the surgical resection rate of young gastric cancer patients is only 20%-26%, and the 5-year survival rate is 11.7%-13.8%, so the prognosis is obviously poor compared with the elderly. Early diagnosis Young people with unexplained anemia, abdominal pain, vomiting, poor appetite and abdominal masses should be particularly concerned: anemia is common among young people with irregular diet and partial diet, who often diagnose themselves as iron deficiency anemia and are too lazy to go to the hospital for consultation. Self-diagnosis requires a principle: if the symptoms do not improve after a period of time, or if the symptoms recur after the medication has improved, you should go to the hospital in time. Of course, it is best to consult a doctor as soon as you find out the problem, this is the safest way.