First, the symptoms:
1 , early gastric cancer : With the progression of the disease , functional status , and the whole body of the stomach gradually changed, these symptoms are often non-specific, can be hidden when , long-term existence . As pain, bloating, dull pain , pain, nausea, loss of appetite, belching , and weight loss , etc. ; minority ulceration (Ⅱ c and Ⅲ type ) early gastric cancer may also have ulcer-like symptoms , was rhythmic pain , acid reflux, medical treatment can alleviate and so on. Some patients with gastric cancer and certain benign or cancerous coexistence on the basis of some benign lesions (such as chronic atrophic gastritis, peptic ulcer , etc. ) , and the symptoms of these diseases, benign stomach has long-standing , or recurrent, make it easier for patients and doctors to relax vigilance against stomach cancer , and delay in diagnosis time. Some of the early symptoms of gastric cancer can also occur vomiting , black stools, or difficulty swallowing and treatment.
① abdominal discomfort : gastric cancer is the most common initial symptoms , approximately 80% of patients with this performance , similar to indigestion, such as abdominal pain , usually beginning minor, and no regularity can not ease after eating , gradually increased, can be pain, dull pain . Rhythm section can have pain, especially gastric antrum more obvious , even to eat or medication can be alleviated. Elderly dull pain , bloating and more to the chief complaint . These symptoms are often not valued by patients , when medical treatment is also often mistaken for gastritis or ulcer disease . Therefore, middle-aged patients if the following conditions should be given further examination , in order to avoid misdiagnosis : A. no previous history of stomach , but the recent unexplained abdominal discomfort or pain , after therapy ; B. with previous history of gastric ulcer , recently on regular change of abdominal pain , and the extent of becoming worse. If symptoms have eased, but the hair of the short-term there should also consider the possibility of gastric cancer in a timely manner for further examination.
② loss of appetite or loss of appetite : loss of appetite and weight loss are common symptoms of gastric times , nearly 50% of patients with gastric cancer have significant loss of appetite or loss of appetite symptoms in some patients because of eating too much can cause bloating or abdominal pain while eating their own restrictions the . Unexplained anorexia and weight loss , it is likely that the initial symptoms of early gastric cancer , need attention. Patients with early gastric cancer is generally no obvious positive signs, most patients in addition to the general condition is weak , but only appeared deep tenderness in the upper abdomen .
2 , advanced gastric cancer : gastric lesions from small to large , from shallow to deep , has transferred from the non- transferred to a gradual process , so early , no clear boundaries between advanced and even late , not only that, between the period symptoms often a great cross , some patients have reached advanced stage disease , but the symptoms are not yet clear, although some of the more prominent early symptom but there are also some patients based on symptoms or symptoms of organ metastasis and treatment of complications . According to the common symptoms of advanced gastric domestic data is as follows:
① abdominal pain : When gastric cancer development and expansion , particularly in penetrating the serosal invasion and violation of the pancreas or the transverse mesocolon , there may be persistent severe pain, to the back of radiation . Very few cancerous ulcer perforation may also occur in patients with abdominal pain and signs of peritoneal irritation .
② loss of appetite and weight loss : the absorption of toxins cancer , patients can become increasingly appears weight loss, fatigue , anemia, malnutrition performance is often aggravated sexual Finally, the performance of cachexia .
③ nausea and vomiting : is also one of the more common symptoms can occur early . Pyloric obstruction of the gastric antrum cancer symptoms may also occur .
④ hematemesis and melena : When cancer surface ulcers, vomiting and melena appeared . 1 /3 of patients with gastric cancer often have a small amount of bleeding, showed more positive fecal occult blood , some intermittent melena may occur , but there are also a large number of vomiting and attenders .
⑤ diarrhea : low stomach acid may be related to a large mushy even be able to have diarrhea just before dawn . Advanced gastric cancer involving the colon often can cause diarrhea , blood will be like.
⑥ dysphagia : After the cancer grow , there may be obstructive symptoms , can cause cancer and gastric cardia or swallowing difficulties , gastric cancer causes symptoms of pyloric obstruction .
Second, the signs:
1 , can not have any signs of early gastric cancer . Only upper abdominal pain or pressure . Most advanced gastric cancer epigastric tenderness . 1 /3 of patients with palpable abdominal mass, hard surface is not smooth , and tenderness , especially suffering from gastric antrum cancer patients more likely to be found in mass wasting . As palpable mass before metastases such as the rectum , the umbilical ascites tumor and lymph nodes appear on the collarbone , is evidence of advanced gastric cancer .
2 , upper abdominal mass, rectal tumor crypt , umbilical mass, left supraclavicular lymph nodes , left armpit lymph nodes, ascites, often prompts have distant metastases. And often occur due to different sites of metastases and the corresponding signs , leaving the clinical manifestations are very complex. If liver metastases can occur , jaundice , etc., can be found in ovarian metastasis of ovarian enlargement and massive ascites, lung metastasis may have breathing difficulties.
3 , in addition, with gastric carcinoma syndrome can also become important signs such as thrombophlebitis , dermatomyositis , etc. Patients may have fever, cachexia .