Gastric cancer is one of the most common malignant tumors, ranking second among digestive tract malignant tumors in China.

The etiology is still uncertain, and it is currently believed to be related to the following factors:

1. Diet and lifestyle factors: People who eat smoked and pickled food for a long time have a high incidence of distal gastric cancer, which is related to the high content of carcinogens or cancer precursors such as nitrite and mycotoxin in food. High-salt diet destroys gastric mucosa and makes carcinogens contact with gastric mucosa directly, which increases the probability of cancer.

2. Helicobacter pylori infection is one of the main factors leading to gastric cancer. The risk of gastric cancer in people infected with Helicobacter pylori is 3-6 times higher than that in people infected with Helicobacter pylori. The role of controlling Helicobacter pylori infection in the prevention and treatment of gastric cancer has been highly valued.

3. Chronic diseases and precancerous lesions: Stomach diseases susceptible to gastric cancer include: gastric polyps, chronic atrophic gastritis, and residual stomach after partial gastrectomy. Gastric polyps can be divided into inflammatory polyp, proliferative polyp and adenoma. The first two are unlikely to be malignant. The canceration rate of gastric adenoma is about 10%-20%, and the canceration rate increases when the diameter exceeds 50px. Precancerous lesions refer to the pathological changes of gastric mucosa that are prone to canceration, which are divided into mild, moderate and moderate. Sometimes it is difficult to distinguish between severe dysplasia and well-differentiated early gastric cancer.

Clinically, staging is definitely necessary for malignant tumors like gastric cancer, that is to say, whether it is early or late is known to everyone, but it is definitely not simple in medicine. There must be some evidence, and the staging should be as clear as possible, so as to provide exact reference for the next treatment.

Staging, mostly according to TNM staging.

T represents the depth of invasion of the primary tumor into the stomach wall, n represents the local lymph node metastasis, and m represents the distant metastasis of the tumor.

Most patients with early gastric cancer have no obvious symptoms, and sometimes there will be non-specific upper gastrointestinal symptoms such as upper abdominal discomfort, fullness and malignant transformation after eating. The patient's symptoms are repeated abdominal distension. With the development of tumor, there are increasing epigastric pain, loss of appetite, fatigue, emaciation and weight loss. Gastric cancer grows in different parts of the stomach and its symptoms are not exactly the same.

Early detection and early treatment

For any tumor, the effect of early treatment is obviously better than that of late treatment, and the 5-year survival rate of early gastric cancer after operation can reach over 90%. Therefore, early diagnosis is the key to improve the cure rate.

Although there are many examination items for gastric cancer, the main examination used to diagnose gastric cancer at present is fiberoptic gastroscope, which can directly observe the location and scope of gastric mucosal lesions and take small pieces of tissue from suspected lesions for pathological persistence. This is the most effective method to diagnose gastric cancer. Ultrasonic gastroscopy can also know the depth of tumor infiltration in the stomach wall, infiltration outside the stomach wall and lymph node metastasis, which is helpful for preoperative clinical staging of gastric cancer. For patients with precancerous lesions of gastric cancer such as atrophic gastritis, gastric ulcer, gastric polyp and subtotal gastrectomy, it is especially necessary to have regular physical examination and gastroscopy.

In terms of treatment, surgery is the main treatment for gastric cancer.

At present, Multidisciplinary Comprehensive Therapy (MDT) is highly recommended for the treatment of tumors. Therefore, in addition to surgery, chemotherapy, radiotherapy, immunotherapy, targeted therapy and even Chinese medicine treatment, it constitutes all aspects of multidisciplinary comprehensive treatment of gastric cancer.

Specific to this patient,

We don't know the cause of gastric cancer.

Judging from the tumor staging, it must be advanced.

In face-to-face treatment, surgery is the first.

I didn't know there was liver metastasis before the operation. If I had known, I might not have had the operation, but if I had not had the operation, the patient would have died. Postoperative chemotherapy and radiofrequency ablation of liver metastases are also important.

More than six years have passed before you know it. Although the psychological trauma and physical trauma brought by gastric cancer to the elderly are enormous, the active and effective comprehensive treatment based on the optimistic psychology of the elderly has given the elderly a new life, which we never expected when we learned that the liver had metastasized after surgery.