What is the best way to diagnose gastric cancer

Gastric cancer is a malignant tumor in the stomach. This disease has no obvious symptoms in the early stage. Many patients tend to ignore the disease in the early stage. When they seek medical treatment, it is often in the late stage, which makes treatment difficult. It also directly threatens the health and life of patients and brings a heavy burden to their families. So what is the best diagnostic method for gastric cancer?

1. Symptoms

The early symptoms are upper abdominal discomfort, which occurs in about 80% of patients. Nearly 50% of gastric cancer patients have obvious loss of appetite or poor appetite. In the late stage, fatigue, back pain, and nausea, vomiting, and difficulty eating may occur after obstruction. Ulcers on the surface of the tumor may cause vomiting of blood and black stools.

2. Physical signs

There are no special signs in the early stage, but in the late stage, a mass can be seen in the upper abdomen. The mass can be felt during rectal examination and the left supraclavicular lymph nodes are enlarged. At the same time, there are cachexia symptoms such as anemia, weight loss, and ascites.

3. Laboratory examination

Early suspected gastric cancer, low or absent free gastric acid, such as decreased hematocrit, hemoglobin, red blood cells, occult blood in stool (+), low total hemoglobin, white/cell inversion, etc., water and electrolyte disorders, acid-base imbalance and other laboratory abnormalities.

4. X-ray manifestations

Double contrast gastrointestinal barium stomatography can clearly show the gastric contour, peristalsis, mucosal morphology, emptying time, the presence or absence of filling defects, niche shadows, etc. The examination accuracy rate is nearly 80%.

5. Fiber endoscopy

It is the most direct, accurate and effective method for diagnosing gastric cancer.

6. Exfoliative cytology examination

Some scholars advocate this examination when clinical and X-ray examinations reveal suspected gastric cancer.

7. Ultrasound

It can be used to understand whether there is metastasis to the surrounding solid organs.

8. CT examination

Understand the invasion of gastric tumor, its relationship with surrounding organs, and whether resection is possible.

9. Immunology

CEA, FSA, GCA, YM globulin and other tests.

Differential Diagnosis

Gastric cancer must be differentiated from gastric ulcer, simple gastric polyps, benign tumors, sarcoma, chronic gastric inflammation, and sometimes also from gastric plica hypertrophy, giant plica disease, gastric mucosal prolapse, pyloric muscle hypertrophy and severe gastric fundus varices. The differential diagnosis mainly relies on X-ray barium meal radiography, gastroscopy and biopsy pathology.

1. Gastric ulcer

Gastric ulcer and ulcer-type gastric cancer are often easily confused and should be carefully differentiated to avoid delaying treatment.

2. Gastric tuberculosis

Gastric tuberculosis is more common in young patients, with a long course of disease, often accompanied by pulmonary tuberculosis and cervical lymph node tuberculosis. Pyloric tuberculosis of the stomach is often secondary to peripyroscopic lymph node tuberculosis. X-ray barium meal examination shows irregular filling defects in the pyloric region. The duodenum is also often involved, and the range is relatively wide, and duodenal deformation can be seen. Multiple creeping ulcers with dark bottoms and gray nodules around the ulcers can be seen during fiber gastroscopy. Biopsy should be taken to confirm the diagnosis.

3. Pancreatic cancer

The early symptoms of pancreatic cancer are persistent upper abdominal pain or discomfort. The disease progresses rapidly, and the abdominal pain is more severe in the late stage. The average time from the onset of symptoms to the time of consultation is generally 3 to 4 months. There is a significant decrease in appetite and weight loss, and the general condition can deteriorate in a short period of time. Symptoms of gastrointestinal bleeding are less common.

4. Gastric malignant lymphoma

It is difficult to differentiate between gastric cancer and gastric malignant lymphoma, but differential diagnosis is of certain importance. Since the prognosis of gastric malignant lymphoma is better than that of gastric cancer, surgical resection should be actively sought. The average age of gastric malignant lymphoma is earlier than that of gastric cancer, the course of disease is longer and the general condition is better. The average volume of the tumor is generally larger than that of gastric cancer. Pyloric obstruction and anemia are relatively rare. Combining X-ray, gastroscopy and exfoliated cell examination can help to distinguish. But in the end, pathological diagnosis is often required.

5. Gastric polyps

It is similar to protuberance-type gastric cancer, but has a long course of disease, develops slowly, has a smooth surface, and is often pedunculated or subpedunculated. It is easy to distinguish by X-ray and gastroscopy, but attention should be paid to the possibility of polyps becoming cancerous, which should be determined by tissue biopsy.

6. Gastric fold hypertrophy

It may be confused with invasive gastric cancer, but its stomach wall is soft and can expand. Under X-ray or gastroscopy, the hypertrophic folds can be flattened or thinned when the stomach cavity is filled.

The above are some diagnostic methods and differential diagnosis of gastric cancer introduced to you today. We know that gastric cancer is a malignant tumor. In treatment, we should choose the appropriate treatment method according to the needs of the disease. Gastric cancer patients should maintain a good attitude, face the disease correctly, and actively receive treatment. They can use drugs under the guidance of doctors to alleviate the side effects during treatment, or they can adjust their diet to alleviate the side effects.