How to do a gastrointestinal cancer check

There are many people in society who have stomach cancer. Since the incidence of stomach cancer is so high, how should we check it? In fact, many people know that there are many ways to diagnose stomach cancer. If we use some effective methods to check, we can more effectively diagnose whether it is stomach cancer. The specific inspection methods are as follows.

1. Physical examination:

There may be enlarged left supraclavicular lymph nodes (the last guard lymph node that enters the blood and spreads throughout the body), an upper abdominal mass, and a mass on the pelvic floor found during rectal examination (cancer cells fall off and grow in the pelvis).

2. Laboratory examination:

Early blood tests are usually normal, while in the middle and late stages, there may be varying degrees of anemia and positive fecal occult blood tests. Currently, there is no tumor marker with strong specificity for gastric cancer diagnosis. Continuous monitoring of multiple markers such as CEA, CA50, CA72-4, CA19-9, and CA242 is of certain value for the diagnosis, treatment, and prognosis of gastric cancer.

3. Imaging examination:

(1) Upper gastrointestinal tract X-ray barium meal contrast: It helps to determine the scope of the lesion. However, early lesions still need to be confirmed by gastroscopy; the main X-ray signs of advanced gastric cancer include niche shadows, filling defects, changes in mucosal folds, abnormal peristalsis, and obstructive changes.

(2) Enhanced CT (computer tomography) can clearly show the extent of gastric cancer affecting the stomach wall, its relationship with surrounding tissues, and whether there are large abdominal and pelvic metastases.

(3) MRI (magnetic resonance imaging) can provide another type of information in determining the extent of cancer. It can be used by patients who are allergic to CT contrast agents or suspected of metastasis by other imaging examinations. MRI helps determine the status of peritoneal metastasis and can be used as appropriate.

(4) PET-CT scan (a combination of positron emission tomography and computer tomography) has an accuracy of more than 80% in determining whether it is gastric cancer and can also determine whether there are metastatic lesions throughout the body. It is painless but expensive. Gastric cancer that is visualized before surgery can be conveniently tracked for gastric cancer recurrence after surgery.

(5) Gastroscopy or laparoscopy and ultrasound:

① It can measure the extent of cancer and preliminarily evaluate lymph node metastasis, which is helpful for preoperative clinical staging, so as to select therapy and judge the efficacy.

② For those diagnosed with gastric cancer by endoscopic pathological biopsy (taking living tissue for pathological examination), endoscopic ultrasound examination can be performed to determine whether it is in the early or advanced stage. Simple endoscopic examination is sometimes difficult to distinguish between early and late stages of gastric cancer.

③ If gastroscopy reveals suspected gastric cancer but pathological biopsy cannot confirm the diagnosis, ultrasound endoscopy can be used to make the diagnosis without the need for the patient to undergo repeated gastroscopy and biopsy.

④ If various preoperative imaging examinations suspect that the lymph nodes are extensively enlarged or that they have invaded important organs and may not be resectable, laparoscopic ultrasound examination can be performed if conditions permit to determine whether there is a boundary between the cancer and the organs to facilitate resection, whether the lymph nodes have metastasized and fused to the extent that they cannot be resected, and which lymph nodes are likely to metastasize.

4. Endoscopic examination:

① Gastroscopy can detect early gastric cancer, differentiate benign and malignant ulcers, and determine the type and range of gastric cancer. If gastric ulcers or atrophic gastritis are found, pathological biopsy is required to evaluate the degree of cellular dysplasia. Severe dysplasia (atypical hyperplasia) needs to be treated as early cancer.

② Laparoscopic examination: hospitals with the necessary conditions can achieve the same effect as laparotomy through this examination, which can provide a detailed understanding of the cancer and the surrounding conditions, especially whether there are extensive miliary-like metastatic cancer foci in the peritoneum, which is difficult to detect with other examinations. Once such a situation occurs, the surgical effect is very poor. If the patient is elderly and in poor health, it may be considered to give up surgery and try other treatments.