What are the main clinical manifestations of gastric cancer patients

Gastric cancer is one of the most common malignant tumors, ranking first among digestive tract tumors. Adenocarcinoma accounts for 95% of gastric malignant tumors. Although gastric cancer is a global disease, the incidence rate varies greatly between sexes, ages, countries and regions, races, and even in the same region at different times.

Early gastric cancer is often asymptomatic, or only has some non-specific digestive tract symptoms. Therefore, it is very difficult to diagnose early gastric cancer based on clinical symptoms alone.

The earliest symptom of advanced gastric cancer is epigastric pain, which is often accompanied by poor appetite, anorexia, and weight loss. The abdominal pain can be acute or slow. At first, it is just upper abdominal distension and discomfort, which is worse after meals, followed by dull pain and discomfort, and occasionally regular ulcer-like pain, but this pain cannot be relieved by eating or taking acid-suppressing drugs. Patients often have early satiety and weakness. Early satiety means that the patient feels full and uncomfortable after eating even though he feels hungry. Early satiety or vomiting is a manifestation of stomach wall involvement, which is particularly prominent in leathery stomach or partial obstruction.

When gastric cancer develops complications or metastases, some special symptoms may occur. When cardiac cancer affects the lower esophagus, dysphagia may occur. When complicated by pyloric obstruction, nausea and vomiting may occur; when ulcer-type gastric cancer bleeds, it may cause vomiting of blood or black stools, followed by anemia. Gastric cancer metastasis to the liver may cause right upper abdominal pain, jaundice and/or fever; metastasis to the lungs may cause coughing, hiccups, hemoptysis, and involvement of the pleura may cause pleural effusion and dyspnea; when the tumor invades the pancreas, radiating pain in the back may occur.

There are no obvious signs in the early stage of gastric cancer. In the advanced stage, a mass can be felt in the upper abdomen with tenderness. The mass is mostly located in the right upper abdomen, which is equivalent to the gastric antrum. If the tumor metastasizes to the liver, it can cause enlargement and jaundice, and even ascites. When there is peritoneal metastasis, ascites may also occur, with shifting dullness. When the portal vein or splenic vein is invaded, there is splenomegaly. When there is distant lymph node metastasis, Virchow lymph nodes can be felt, which are hard and immobile. A plate-like mass can be felt in the rectovesical pouch during digital rectal examination.

Some patients with gastric cancer may develop paraneoplastic syndrome, including recurrent superficial thrombophlebitis (Trousseau sign) and hyperpigmentation; acanthosis nigricans (excessive pigmentation in skin folds, especially in the axillae), dermatomyositis, membranous nephropathy, and neuromuscular lesions involving sensory and motor pathways.