General symptoms: epigastric distension and pain, emaciation, loss of appetite, diarrhea, weakness, etc. 2. Special symptoms: when there is pyloric obstruction, there may be nausea and vomiting, and the vomit is overnight food with rotten odor; when there is perforation, there may be sudden and severe abdominal pain; when there is bleeding, there may be vomiting blood and black stool. 3.Other: Difficulty in swallowing is a typical symptom of cardia obstruction in cardia cancer. Patients in advanced stage may have swelling. If liver, ovarian, abdominal or umbilical metastasis occurs, corresponding symptoms may be produced. General signs: Generally, there are no obvious signs of gastric cancer, some patients have mild pressure pain in the upper abdomen, the scope of which is larger than that of ulcer disease, and a few patients have rebound pain in the upper abdomen. Sometimes a lump can be found in any part of the upper abdomen of the stomach, most commonly in the right upper abdomen. Metastatic lymph nodes can be found in a few patients, with supraclavicular lymph nodes being the most common, followed by axillary lymph nodes. When metastasis occurs in the intra-abdominal organs or peritoneum, ascites often appears. 2, special signs: when pyloric obstruction is present, there may be gastric pattern, vibro-hydraulic sound, left upper abdominal percussion drum sound. When perforation is present, there may be muscle tension rebound pain and mobile turbid sounds. When there is bleeding, there may be vomiting blood, blood in stool, anemic appearance, pale lid conjunctiva, and signs of shock. 3.Other: advanced patients may have anemia, emaciation and cachexia. Gastric cancer metastasis or compression of intestinal canal may produce symptoms of intestinal obstruction, and liver metastasis may have hepatomegaly, jaundice and ascites. Pre-operative routine examination 1.Gastroscopy, ultrasonic gastroscopy if necessary. 2.3D enhanced CT examination of the stomach. 3.Gastrointestinal gas-barium double imaging. 4.Bilateral adnexal ultrasound examination (female). 5.Chest X-ray or chest CT …… 6.Electrocardiogram (or add dynamic ECG examination). 7.Lung function test. 8, blood system examination: blood routine, blood type, hepatitis series, HIV, syphilis, liver function, kidney function, ion, blood sugar, CEA, CA19-9, AFP, coagulation test, urine routine, stool routine. IV. Indications for surgery 1. Clear pathological diagnosis 2. Systemic status: if poor, should be corrected to near normal. 3.Tumor condition: whether the mass is resectable, whether there is distant metastasis 4.Liver function 5.Kidney function 6.Heart function 7.Lung function 6.Treatment items of gastric cancer 1.Surgical treatment 2.Chemical drug treatment 3.Immunobiological treatment 4.Radiotherapy 5.TCM or combined Chinese and Western medicine treatment 6.Gastric endoscopic treatment: EMR, ESD, etc. 7.Other treatments: thermotherapy, ultrasonic knife treatment, X-blade treatment, etc.