What Is Adenocarcinoma of the Stomach?

Gastric adenocarcinoma is a type of gastric cancer that is caused by the malignant transformation of gastric glandular cells, so it is called adenocarcinoma. Gastric adenocarcinoma accounts for 95% of gastric malignancies. Relatively rare are lymphomas (which can only be found mainly in the stomach) and leiomyosarcoma. The incidence of gastric cancer varies around the world; for example, Japan, Chile and Iceland have a very high incidence. In the United States, gastric cancer is most common in northerners, the poor, and blacks, but its incidence has decreased to about 8.1 million, which is the seventh leading cause of cancer deaths. However, in Japan, the incidence of gastric cancer has decreased, but still Is the most common malignant tumor, its incidence increases with age, more than 75% of patients are older than 50 years old.

Gastric adenocarcinoma

Gastric adenocarcinoma is a type of gastric cancer that is caused by the malignant transformation of gastric glandular cells, so it is called adenocarcinoma. Gastric adenocarcinoma accounts for 95% of gastric malignancies, and is relatively rare

What is gastric adenocarcinoma

The incidence of gastric adenocarcinoma accounts for 95% of gastric malignancies. Relatively rare are lymphoma (which can only be located mainly in the stomach) and leiomyosarcoma. The incidence of gastric cancer varies around the world; for example, Japan, Chile and

Gastric cancer can be classified according to gross morphology as follows: (1) Raised type-the tumor is a polypoid or umbrella type; (2) Penetrating type-the tumor has a clear boundary and may have ulcers; (3) Disseminated type-the tumor spreads along the mucosal surface , Or infiltration in the wall. If there is an ulcer, the edges are unclear or piled up. If the gastric wall is infiltrated with tumors and accompanied by fibrosis, a leather-like stomach (sclerotic gastritis) can be formed; (4) Mixed type-has the characteristics of the other two types, and this type has the largest number. The prognosis of the raised type is better than that of the invasive type. The size of the tumor has nothing to do with the risk of concurrent metastasis. The smallest tumor may have distant metastases at the time of detection.

The histological classification of gastric cancer is based on the arrangement of cells into a normal-looking tubular gland and the degree of cell differentiation, and has an appropriate correlation with gross morphology and prognosis.

The Japan Gastrointestinal Endoscopy Association (1962) classified early gastric cancers, that is, cancers that are limited to the mucosa and submucosa, according to the general morphology: type -raised type; type -superficial type (slightly raised, flat or Shallow concave type); type III-concave type.

There are no special symptoms of early gastric cancer. Patients and doctors pay little attention to the number of symptoms that appear or longer. A careful inquiry can reveal a series of clues. If the cancer partially blocks the pyloric area, early satiety (including swelling or (Bloating). Pain may remind people

Generally can be tested in the hospital by the following inspection methods:

1. blood routine and

Differential diagnosis often includes peptic ulcer and its complications.

Endoscopy allows direct observation and biopsy of suspicious areas. Multiple specimens should be collected from the edge of the gastric ulcer for biopsy, and cell brushes should be taken from the base and edge. Biopsy limited to the mucosa sometimes misses the submucosa. Tumor tissue, in high-risk populations (such as Japanese), endoscopy is used for censuses.

Cellular gastroscopy is helpful for these situations, and special techniques (such as spraying the tumor surface with a water beam during endoscopy or scraping the tumor surface with an instrument) can get more positive scrubbing fluid. Skilled people use cell brushes and take at the same time Biopsy can improve the effectiveness of the examination.

X-ray examination is not reliable in detecting small early lesions. However, Japanese radiologists use a double contrast technique, which covers the mucosa with barium and inflates the stomach to show slight changes in the mucosa, and found that the diameter < 1cm of cancer.

Gastric fluid analysis is not significant.

If possible, resection of the tumor is the only hope for cure. If the tumor is limited to the mucosa and submucosa, the prognosis is good. In the United States, the vast majority of patients have a wide range of tumors during surgery, so the effect is poor. In Japan, It is found that early gastric cancer is better through surgical screening. Primary lymphoma of the stomach has better surgical effect than cancer. It may survive long-term and even cure, especially malignant lymphoma. For patients with gastric adenocarcinoma with malignant ulcers The good outcome is probably because the ulcers made them see the doctor early. Chemotherapy may be of palliative value to patients with metastatic tumors; combined use of radiation and chemotherapy can be used for patients with unresectable local tumors, but the results are generally disappointing. Adjuvant chemotherapy or a combination of chemotherapy and radiation after gastrectomy is still in the validation stage.

Surgery for cancer involves removal of most or all of the stomach and its adjacent lymph nodes. Metastatic or extensive tumors cannot be cured. Whether palliative surgery (such as gastrointestinal anastomosis of the pyloric obstruction bypass) depends on whether the patient's life can be improved quality

Gastric adenocarcinoma is not very sensitive to radiotherapy and chemotherapy, but it can be used as an adjuvant method for gastric adenocarcinoma. Radiotherapy for gastric adenocarcinoma is applied before and during surgery. The postoperative effect is not good, and it is often not used. Generally, it is supplemented with traditional Chinese medicine for gastric cancer. Preoperative radiotherapy can kill and inhibit gastric adenocarcinoma cells, shrink the tumor, facilitate surgical resection, increase the resection rate, and expand the indications for surgery; intraoperative radiotherapy can eliminate the unresectable residual gastric adenocarcinoma lesions or the invisible gastric glands. Cancerous foci. And for the treatment of gastric adenocarcinoma

Nearly half of the patients with early gastric cancer have no clinical symptoms, and only some have mild indigestion and other symptoms, such as epigastric pain, mild fullness, pain, nausea, and belching.These symptoms are not unique to gastric cancer and can be seen in chronic gastritis and ulcers. ,

Symptoms of gastric adenocarcinoma are often more obvious, mainly including local advanced symptoms and extensive metastatic spread symptoms. Late symptoms of gastric adenocarcinoma often include hoarseness, chest pain, shortness of breath, fever, and hemoptysis, which bring great pain to patients. In general, the treatment of advanced gastric adenocarcinoma is mainly based on controlling symptoms to stabilize the disease. Local advanced symptoms of gastric adenocarcinoma: hoarseness: it is a common symptom of advanced gastric adenocarcinoma, because the tumor continues to swell and invade the left side of the mediastinum Lateral compression of the recurrent laryngeal nerve causes patients to hoarse, patients generally do not have upper respiratory symptoms or sore throat response. Chest pain: intermittent pain or suffocation, gastric adenocarcinoma progresses to advanced stages, tumor invasion and pleura cause increased pain, shoulder and back pain , Upper limb pain, interphalangeal neuralgia, etc., can generally make patients pain unbearable. Improving the quality of life of patients with advanced lung cancer. Shortness of breath: Tumor obstruction of lung lymph nodes or large bronchial tubes can cause pleural effusion or shortness of breath, causing patients with chest tightness, shortness of breath or asphyxia, which is life-threatening. Fever: Bronchial obstruction caused by tumor invasion Compression of the lumen or cavity formation in the tumor can cause inflammatory fever symptoms.

What are the vulnerable groups of gastric cancer? In recent years, gastric cancer has become younger and more common in people under the age of 40. Gastric cancer in young people has the characteristics of rapid progress, short course of disease, and dangerous prognosis. The direct cause of this consequence is that young people often do not pay much attention to the early signs of gastric cancer. Usually, when they experience an onset of stomach pain, they think they are common stomach diseases and do not seek medical treatment in time, which often delays the early diagnosis. Gastric cancer should be detected early or it is difficult to cure. Some people are particularly vulnerable to gastric cancer. Here are some of the people who are susceptible to gastric cancer.

I. Diet: Excessive salt intake increases the risk of gastric cancer. Long-term intake of high salt can corrode and damage gastric mucosa, leading to chronic gastritis. Salted vegetables or smoked meat and fish contain a large amount of nitrates and nitrites, which can be converted into strongly carcinogenic N-nitroso compounds in the stomach. At the same time, eat a lot of red meat, especially grilled Red meat also increases risk.
Second, smoking and drinking, the risk of gastric cancer is increased by 5 times: people who smoke daily have an 88% increased risk of developing gastric cancer than non-smokers, and the earlier the age at which they start smoking, the more they smoke daily and the longer they continue to smoke Longer, the higher the risk of gastric cancer. Compared with non-smokers, those who smoked more than 20 cigarettes a day and drank more than 5 times every 2 weeks had a 4.9-fold increased risk of non-cardia gastric cancer.
3. Men: Men have twice as many women with stomach cancer as women.
4. Age: Most patients with gastric cancer are between the ages of 40 and 80. People under the age of 40 are relatively less likely to develop gastric cancer. However, it is not uncommon for young patients in China.
5. Introverted and sullen people are prone to stomach cancer: After encountering a series of stressful or sad life events, lymphocyte activity decreases and immune function is suppressed, creating conditions for tumorigenesis. The Epidemiology Group of the Beijing Cancer Institute used a self-made personality scale to test gastric cancer and other cancer patients. It was found that patients with gastric cancer have the characteristics of "introverted and sullen". Most of them are depressed, introverted and inflexible.
Environmental factors: People who work for a long time in environments containing large amounts of smoke, asbestos and nickel have an increased risk of gastric cancer.
7. Obesity: Men with a weight of 20 to 25 kg over normal weight are at higher risk for gastric cancer.
8. Economic status: The incidence of gastric cancer is higher in poor economic areas, which may be related to poor sanitary habits in less-developed areas, H. pylori is more likely to be transmitted, and refrigerators have not yet spread, and foods are prone to spoilage.
Nine, family history of stomach problems: If your parents or siblings have stomach cancer, you are more likely to have stomach cancer. For hereditary diffuse gastric cancer, if a parent has a genetic mutation, it is 50% more likely to be passed on to each child. If you have a family history of diffuse gastric cancer, you should ask your doctor about DNA testing.
10. Malignant anemia: Malignant anemia is often associated with atrophic gastritis. When your stomach cannot produce a protein that helps endogenous factors absorbed by vitamin B12, it can lead to malignant anemia. Although pernicious anemia can be easily cured by injecting vitamin B12, the disease slightly increases the risk of gastric cancer.
11. Type A blood: Type A blood is determined by the two proteins-A antigen and B antigen-that are present on red blood cells in the blood. For unknown reasons, people with blood type A are more likely to develop stomach cancer than people with other blood types.
12. Stomach Surgery: Those who underwent partial stomach and pylorectomy were more likely to develop gastric cancer. Stomach cancer that protects the stomach has reduced the number of bacteria that cause nitrite production. These factors can cause stomach cancer in some people. About 20 years after the first operation on the stomach is a high-risk period for gastric cancer.
Thirteen, gastric polyps: Polyps are small tumors growing in the gastric mucosa. Most of the polyps are benign, but adenomatous polyps, especially those with a diameter of about 1 cm, are often a precancerous lesion.
14. Region of life: Gastric cancer is more common in parts of Japan, China, Korea, Latin America, and Eastern Europe, which is related to dietary structure and Helicobacter pylori infection. Stomach cancer has a higher incidence in areas where meat is consumed in large amounts or in smoked, cured and salty foods.
15. Familial tumor diseases: Hereditary diseases such as hereditary nonpolyposis intestinal cancer and familial adenoma polyps can slightly increase the risk of gastric cancer.