Direct infiltrative spread: The direct infiltrative spread invasion is related to the location of gastric cancer, cardia cancer of gastric fundus mostly invades esophagus, liver and greater omentum, and gastric body cancer mainly invades greater omentum, liver and pancreas, its spread mode is mainly in subplasma infiltrative cancer cells crossing the pyloric ring or submucosal cancer cells spreading through lymphatic vessels, rarely it spreads along the mucosa directly and continuously, but proximal cancer is different, it can directly expand and invade lower esophagus. Lymph node metastasis: according to the distance from the cancer focus, it is divided into the first, second and third stations and distant lymph nodes. The first station is the lymph nodes near the cancer focus, such as the large and small curvature of the stomach, above and below the pylorus, next to the cardia, and at the splenic portal; the second station is the lymph nodes next to the spleen, the common liver, the left gastric artery, and the posterior duodenum of the pancreas; the third station is the lymph nodes next to the celiac artery, the hepatic portal, the mesenteric aorta, and the lymph nodes around the middle colonic artery; the distant lymph nodes are mediastinal and left supraclavicular fossa or bilateral supraclavicular lymph nodes (Virehow lymph nodes). The pattern of lymph node metastasis: Generally, the metastasis is from near to far and spreads widely through lymphatic tracts, mostly diffuse gastric cancer, and the cancer cells metastasize to the right supraclavicular lymph node through the thoracic duct, which sometimes becomes the first clinical symptom and sign. Since tumor growth and dissemination can lead to aneurysmal obstruction of some lymphatic vessels, while other lymphatic vessels are re-formed to compensate for the lack of lymphatic outflow from the stomach, cancer cells can not only spread along the local lymph, but also along the constantly opening lymphatic vessels, forming distant lymph node metastasis. Hematogenous metastasis: late stage patients can account for 64% of the metastases. Among the metastases of various organs, liver is the most common accounting for 40%, lung for 30%, followed by pancreas, adrenal gland, bone, kidney, spleen, brain, skin, etc. Implantation metastasis: cancer cells are detached from the plasma membrane and planted in the peritoneum to form many metastatic nodules, producing a large amount of ascites, and there may be metastasis in the rectal fossa.