There are two major risk factors for the occurrence of gastric cancer
I. Individual factors
①Blood group factor, the incidence of A blood group is high;
②Gastric cancer has family aggregation;
③Mental factors;
④ Chronic atrophic gastritis, gastric ulcer, gastric polyps and other diseases.
Environmental factors
① chemical factors such as lack of or high trace elements;
②Microbial contamination factors, such as fungal, bacterial contamination;
③Dietary factors, frequent consumption of fresh vegetables, fruits and protein foods has a protective effect, while eating high starch, heavy salt, pickled, smoked and fried foods and poor dietary behavior have a high incidence of gastric cancer.
Clinical manifestations
Symptoms
(1) More than 70% of early gastric cancer have no obvious symptoms. As the disease develops, non-specific symptoms such as gastritis or gastric ulcer may gradually appear, including upper abdominal fullness and discomfort or hidden pain, acidity, belching, nausea, as well as vomiting, loss of appetite, black stool, etc.
(2) Symptoms of progressive gastric cancer include pain in the stomach area, which is not obviously related to eating, or similar to peptic ulcer pain, which can be relieved after eating. The symptoms include feeling of fullness and heaviness in the upper abdomen, anorexia, abdominal pain, nausea, vomiting, diarrhea, emaciation, anemia, edema, fever, etc.
(3) Cardia cancer mainly manifests as discomfort under the saber, pain or pain behind the sternum, accompanied by the feeling of obstruction in eating or difficulty in swallowing; cancer of the fundus and lower cardia often has no obvious symptoms, but may be paid attention to after the tumor infiltration extends to the cardia and causes difficulty in swallowing; cancer of the body of the stomach is more common in the distended type, and the pain and discomfort appear later; cancer of the ulcerated type is most common on the side of the small curve of the gastric sinus, so the symptoms of epigastric pain appear earlier; if the tumor extends to the pylorus, the pain may appear earlier. If the tumor extends to the pylorus, it can cause nausea, vomiting and other symptoms of pylorus obstruction.
(4) Tumor spread and metastasis can cause ascites, hepatomegaly, jaundice and metastasis of lung, brain, heart, prostate, ovary, bone marrow, etc., and the corresponding symptoms appear.
Physical signs
Most patients with gastric cancer have no obvious signs, some of them have mild pressure pain in the upper abdomen; progressive gastric cancer located in the pylorus or gastric body can sometimes find a mass, and when the tumor infiltrates into adjacent organs or tissues, the mass is often fixed and cannot be pushed; in female patients, finding a mass in the lower and middle abdomen often indicates the possibility of tumor; when liver metastasis occurs in gastric cancer, enlarged liver or nodular masses can be palpated; in those with pyloric obstruction, dilated gastric pattern can be seen in the upper abdomen. When gastric cancer has pelvic implantation, nodules can be found in the rectal fossa of the bladder (uterus) on rectal finger examination; ascites can appear when there is peritoneal metastasis; narrowing of the intestinal lumen due to small intestine or mesenteric metastasis can lead to partial or complete intestinal obstruction; when cancer perforation leads to diffuse peritonitis, abdominal muscle plate stiffness, abdominal pain and other peritoneal irritation symptoms. peritoneal irritation symptoms such as pressure pain.
Common complications
(1) When complicated by gastrointestinal bleeding, dizziness, palpitations, resolution of tarry stools and vomiting of coffee-colored material may occur.
(2) Jaundice may occur when the common bile duct is compressed by abdominal metastasis of gastric cancer.
(3) Combined with pyloric obstruction, vomiting, dilated gastric pattern in the upper abdomen, and vibroscopic sound can be seen.
(4) Diffuse peritonitis caused by cancer perforation may result in peritoneal irritation such as abdominal muscle stiffness and abdominal pressure pain.