Ms. Liu, 36, is a housewife who usually does not smoke or drink and has a healthy lifestyle.
At the end of 2019, she always felt stomach pains, and her stomach bloated after eating, “as if something was on top.”
After three weeks of procrastination, she finally decided to go to the hospital in January 2020, and her doctor recommended a painless gastroscopy.
This was her first gastroscopy, and the results were like a bolt from the blue – Ms. Liu had a locally advanced gastric Indolent cell carcinoma with metastasis in the surrounding lymph nodes. The doctor sighed and recommended surgery as soon as possible.
When it comes to gastric ring cell carcinoma and “leather stomach,” many people will recall the story of 34-year-old Internet singer Goen.
(Source: screenshot of Goon’s Weibo)
I believe many people are sympathetic and sorry, but it is also the first time they have heard of such a strange name as “leather stomach” and “printed ring cell carcinoma”.
How dangerous is this stomach cancer that even doctors are sighing? In fact, young people in particular should take a look.
“Leather stomach” is a type of gastric cancer
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The term “leather” to describe a malignant tumor of the digestive tract was first suggested by the English surgeon William Brinton in 1854.
But leather is not just for the stomach; there are also “leather colon” and “leather rectum,” which are, as the name implies, stiff and inflexible like leather.
Leather stomach, a type of progressive gastric cancer.
This stage is usually intermediate or advanced, and is more common in men than women.
This type of cancer does not grow like a “tumor” and does not form deep ulcers, but diffuses and penetrates into all layers of the stomach wall.
(Bormann staging of gastric cancer, type IV is leathery stomach)
The stomach wall thickens and hardens, gradually becoming as stiff as leather, as if it has developed an “invulnerable body”.
The “small folds” (folds) in the stomach mucosa disappear and the stomach cavity shrinks, so you can’t eat and you’re often bloated.
In the advanced stage, most patients’ stomachs have basically lost their peristaltic function and resemble a leather pocket, hence the name “leather bag stomach”.
The vast majority of pathological biopsies of the leathery stomach say “hypofractionated carcinoma” “undifferentiated carcinoma” or “indolent cell carcinoma” with a high degree of malignancy.
What does “indolent cell carcinoma” mean?
Simply, this is a histologic staging of gastric cancer, which is determined by “what the cancer cells look like.
Indolent cell carcinoma is the younger brother of the adenocarcinoma family, with other siblings including papillary, tubular, and mucinous carcinomas.
Alongside the adenocarcinoma family are adenosquamous, squamous, and undifferentiated carcinomas.
The name comes from the fact that the cells in an indolent cell carcinoma are filled with mucus and the nuclei are pushed to the side, looking like a ring.
(Microscopic smear of an indolent cell carcinoma)
Indolent cell carcinoma is a special type of gastric cancer because of its high malignancy, aggressiveness, and rapid progression.
Progressive invasive cell carcinoma often shows significant fibrosis or sclerosis, and the entire stomach may become “leathery” if detected late.
So, like a brother and sister, Indocellular carcinoma and “leathery stomach” often appear together.
Indolent cell carcinoma of the stomach also likes young people, but prefers young women. This is different from the leathery stomach, which is more common in men.
This may be related to the high estrogen metabolism in young women, so girls must pay more attention!
“Leather stomach” is very cunning, good at lurking and camouflage
“Leather stomach” is dangerous, but the symptoms are very insidious and not easily detected in the early stages.
In the early stages, most patients don’t even have obvious symptoms, they may just feel smaller meals, get full quickly, etc.
Some patients may experience upper abdominal discomfort, fullness after eating, decreased appetite, nausea, or symptoms similar to ulcer disease.
It is only as the disease progresses that symptoms such as increased epigastric pain, weight loss, and fatigue occur.
But unfortunately, most people wait until their stomach is very painful and they lose weight before they go to the doctor, by which time it is found to be intermediate or advanced, and even lymph node metastasis has occurred.
This is why there are so few early stage patients with “leather stomach”.
Do the different “leather stomachs” have different symptoms?
Yes, there are.
Yes, because the tumor is in a different location.
(Anatomical parts and divisions of the stomach)
- For example, people with lesions in the cardia and fundus (both in the upper part of the stomach) may have progressively worse dysphagia and retrosternal pain;
- People with lesions in the pylorus (lower part of the stomach) may present with manifestations such as vomiting up a hangover (vomiting out hours after eating);
- If persistent stomach pain, swollen supraclavicular lymph nodes, ascites, abdominal masses, etc. occur, they may indicate that the cancer has spread, and these are all manifestations of middle to late stage of gastric cancer.
The basic tests for “leather stomach” are gastrointestinal imaging, gastroscopy, ultrasound, and CT.
While many patients are first detected by gastroscopy, sometimes, gastroscopy and biopsy results can be negative, fooling the doctor.
This is when the combination of a barium meal (dual gastrointestinal X-ray), ultrasound, and other tests such as CT can help confirm the diagnosis and determine if the cancer has metastasized.
How should I treat my “leathery stomach”?
Unfortunately, “leathery stomach” is often short and fast moving, with poor outcomes and results.
The survival time is usually less than a year, and most patients go from hospital visit to death in 3 months to 6 months.
So once diagnosed, it is important to treat the disease with surgery as early as possible, with radical resection if possible.
After a partial or complete stomach is removed, the surgeon connects the remaining stomach, intestines, and esophagus, which is called “reconstructing the digestive tract.
(Methods of GI reconstruction)
If the primary lesion has metastasized and cannot be removed, it is also important to perform palliative surgery if possible, supplemented by chemotherapy to improve the patient’s symptoms and allow the tumor to grow more slowly.
Of course, the physician will treat the patient in a comprehensive manner on a case-by-case basis. The goal of all treatments is to slow disease progression and help patients improve their quality of life and prolong survival.
The top priority is prevention and early detection
China has one of the highest incidence and mortality rates of gastric cancer in the world, and there is a trend toward younger age, related to factors such as genetics and poor lifestyle habits.
People may be at high risk for gastric cancer if they have any of the following conditions:
- In areas with a high incidence of gastric cancer (e.g., northwest, southeast coastal areas)
- History of gastric cancer in first-degree relatives such as parents and siblings;
- Have H. pylori infection;
- Have previous diseases such as chronic atrophic gastritis, hypertrophic gastritis, gastric polyp, gastric ulcer, pernicious anemia;
- eating heavy meals (high salt diet), eating pickled foods for a long time, eating too little vegetables and fruits, smoking, heavy alcohol consumption, etc.
For people at high risk, regular gastroscopy is recommended starting at age 40.
(Painless gastroscopy)
For the low-risk general population, this should not be taken lightly. Any symptoms such as epigastric pain, acid reflux, heartburn, nausea, difficulty swallowing, anemia, black stool, and unexplained weight lossshould be followed by a gastroscopy as soon as possible!
Only early detection and early treatment can buy yourself more survival time.
I would also like to remind all young people here, don’t think you can carry it because you are young! Crises in the body are accumulated unknowingly.
It is because you are young that you should pay more attention to healthy diet, stay away from smoking and alcohol, regular work and rest, reasonable exercise, and regular medical checkups. Only then can you keep cancer away from you!