I. Risk factors of gastric cancer?
1.Individual susceptibility (related to genetic predisposition)
2.Decreased immune function.
3, stimulation by mental factors.
4, poor living habits (irregular, moldy, overheated food, smoking and drinking)
5, environmental pollution.
6.H. pylori infection.
Precancerous lesions of gastric cancer?
1, chronic atrophic gastritis (incidence 1.5%)
2.Gastric polyp (diameter greater than 2cm, no tip)
3, postoperative residual gastritis (associated with bile reflux)
4.High-grade intraepithelial neoplasia.
Symptoms of gastric cancer?
1.No obvious symptoms in early stage.
2. Non-specific symptoms (symptoms of gastritis and peptic ulcer – upper abdominal fullness and discomfort, vague pain, acidity and eructation, nausea and vomiting, vomiting blood and black stool, poor appetite and diarrhea, anemia and emaciation, etc.).
4.Signs of stomach cancer?
1.abdominal mass (if the mass is fixed, resection is very unlikely)
2.Left supraclavicular mass (lymph node metastasis foci).
3.Jaundice (advanced stage).
4, ascites (advanced stage).
V. The manifestations of gastric cancer in different parts?
1.Gastric sinus: ulcerative type – abdominal pain is common.
2.Pylorus: pyloric obstruction – nausea and vomiting
3, fundus cardia: discomfort in the heart fossa – difficulty in swallowing
4.Gastric body: vomiting blood and black stool – upper gastrointestinal bleeding.
How does gastric cancer metastasize?
1.Direct infiltration (invasion of liver, pancreas, bile duct, transverse colon, spleen, greater omentum)
2.Lymphatic metastasis (lymph nodes metastasize in a sequential or jumping pattern)
3, hematogenous metastases (liver, lung, bone metastases)
4.Pelvic and peritoneal implantation metastasis (metastasis to ovary, pelvis, abdominal wall).
VII. CT manifestations of gastric cancer?
1, limited thickening of the stomach wall.
2.Soft tissue mass.
3.Unclear contour of stomach.
4, indistinct boundary between stomach and adjacent organs
5. Enlarged lymph nodes around the stomach.
VIII. Endoscopic examination of gastric cancer?
1.Determine the site of gastric cancer.
2.Tracing precancerous lesions and finding microscopic lesions.
3, biopsy.
4.Endoscopic resection of precancerous lesion or early cancer.
IX. Treatment options for gastric cancer?
1.Stage I (early stage cancer, invading mucosa or submucosa, no lymphatic metastasis): surgical resection is the main treatment.
2.Stage II (middle stage, invading the muscular layer or plasma layer, with lymph node metastasis)–surgery plus chemotherapy.
3, Stage III (intermediate – late stage, invasion of surrounding tissues, lymphatic metastases) – surgery plus chemotherapy or radiotherapy, immunotherapy, Chinese herbal medicine.
4.Stage IV (advanced stage, distant metastasis): resection of primary foci or metastases (tumor reduction surgery or shortcut rerouting surgery), together with chemotherapy, radiotherapy, immunotherapy, and Chinese herbal medicine treatment.
X. Surgical treatment of gastric cancer?
1. Determine the scope of surgical gastric cancer resection, the scope of lymph node dissection and the way of digestive tract reconstruction according to the tumor site, size, infiltration range, lymph node metastasis and the presence of distant metastasis (TNM stage).
2. The surgeon’s technical level, the patient’s surgical ability, the safety of surgery and the patient’s postoperative quality of life should be considered comprehensively.