Follow us!
Cancer Prevention and Treatment Awareness Week
April 15-21, 2024 is the 30th "National Cancer Prevention and Treatment Publicity Week", and the theme of this year's publicity week is "Comprehensive Policies and Scientific Cancer Prevention".
Stay away from the king of stomach cancer: "signet ring cell stomach cancer"
Recently, I consulted an expectant mother who was 30 weeks pregnant, and her back pain was very severe, and there was no problem with electrocardiogram and color ultrasound, but after examination, she suspected that there was a gastrointestinal problem. But I didn't have a gastrointestinal endoscopy before I got pregnant, and now I'm more than 7 months pregnant. Because I am afraid that it will have a bad impact on the baby, I really have no choice but to do an ordinary gastroscopy. Examination found that the mucosa of the entire gastric cavity was thickened and thickened, and a huge ulcer was necrotic with bleeding (as shown in the picture), and no matter how much air was sent inside, it could not be supported. It turned out that the cunning disease had already planted seeds under the mucous membranes, which quietly infiltrated until the stomach became smaller, harder, and unable to contract. This is what we often call a typical "leather stomach" in medicine.
The family is facing the soul torture of "protecting adults or children?", because his family has three generations of single transmission, so she is determined to protect the child.
Later, after a consultation with experts from all over the hospital, the patient and his family finally underwent active surgery and had a caesarean section to save the baby, and at the same time wanted to cut out the stomach cancer. Unfortunately, the surgery found that the abdominal cavity had metastasized and could not be treated surgically. Pathology also confirmed that it was poorly differentiated gastric adenocarcinoma, some of which was "signet ring cell carcinoma", and cancer cells were also found in the abdominal cavity.
"Signet Ring Cell Carcinoma" is a special type of poorly differentiated mucinous adenocarcinoma with strong aggressive ability, and it can be seen under the microscope that there is a large amount of mucus in the cancer cells, and the nucleus is squeezed aside to look like a ring, so it is called "signet ring cell carcinoma". Even if the lesion of "signet ring cell carcinoma" is small, it is still easy to metastasize and progress, and it is common in the gastrointestinal tract, breast and other parts, and is more common in young people. Due to the extremely high degree of malignancy, "signet ring cell gastric cancer" is often called the "king of gastric cancer".
In fact, "signet ring cell gastric cancer" is very good at camouflage, early patients do not have any symptoms, small lesions, even if gastroscopy is done, it is difficult to find, it may be a little erosion on the surface. Therefore, it is easy to misdiagnose and miss, and most "signet ring cell carcinoma" is already advanced when it is discovered, and even after active treatment, it rarely has a chance to live past five years. This has brought pain to the family and society that can never be erased.
The same signet ring cell gastric cancer, this 25-year-old young man, because of stomach discomfort to do a gastroscopy, the attending doctor is experienced and extremely careful, found < 1 cm early "signet ring cell carcinoma", immediately performed gastroscopic submucosal resection (ESD) surgery. Now in its 8th year, I have a check-up every year, and I have always been healthy.
According to the latest data, in 2022, there will be 509,000 new cases of gastric cancer and 400,000 deaths from gastric cancer in China, accounting for about half of the world's total. Among them, "signet ring cell carcinoma" accounts for about one-tenth.
In view of the current situation of "the largest country for gastric cancer", mainland experts have updated and revised the Guidelines for Early Diagnosis and Treatment of Gastric Cancer Screening (2022 Edition), the Public Guidelines for Gastric Cancer Risk Management in the Chinese Population (2023 Edition) and the Guidelines for the Diagnosis and Treatment of Gastric Cancer (2023 Edition), which meet any of items 1 and 2~6 should be listed as high-risk groups for gastric cancer, and are recommended as routine screening objects:
Subjects of routine screening for gastric cancer
Age 45 years old or above, male or female;
Long-term residence in areas with a high incidence of gastric cancer (Liaodong Peninsula, Shandong Peninsula, Yangtze River Delta, Taihang Mountains, etc.; high-incidence provinces: Liaoning, Fujian, Gansu, Shandong, Jiangsu, etc.);
幽门螺旋杆菌(Helicobacter pylori, Hp)感染者;
Previous gastric precancerous diseases such as chronic atrophic gastritis, gastric ulcer, gastric polyps, postoperative residual gastritis, hypertrophic gastritis, pernicious anemia, etc.;
First-degree relatives of gastric cancer patients;
Presence of other risk factors for gastric cancer (high salt, pickled diet, smoking, heavy alcohol consumption, etc.).
In fact, based on our experience, the first recommendation about the age of 45, the 2019 guideline recommends 40 years old. In other words, the first gastroscopy should be before the age of 40, especially if there is a family history or genetic predisposition, it should be advanced.
Especially in recent years, more and more people in their teens and twenties have died of cancer, which makes people sigh. Recently, our team treated an 8-year-old child with stomach cancer, who had no family history and passed away in less than 1 year.
Of course, once there is belching, stomach pain, stomach distention, weight loss, blood in the stool and other discomforts, don't delay, don't forget to rule out tumors, because the most expensive medicine in the world is "regret medicine".
We are all small, and there are so many things that we can't change. In the midst of these uncertainties, the only thing we can be sure of is to do a gastroscopy earlier to give a different future. Perhaps, a physical examination winter has become a story, and a gastroscopy spring has become a landscape.
In short, early detection, pay attention to physical examinations, maintain a healthy lifestyle, and stay away from the "king of stomach cancer", let us work together to keep more people away from the threat of this disease.
Reminder at the end of the article
This article introduces the knowledge of common signet ring cell carcinoma, mainly about the screening, diagnosis and treatment of early gastric cancer. Readers are reminded that each patient's situation is different, and the specific treatment plan needs to be developed under the guidance of a doctor.
What is signet ring cell carcinoma?
"Signet ring cell carcinoma" is a special type of poorly differentiated mucinous adenocarcinoma that is commonly found in the gastrointestinal tract, breast and other sites. It is more common in young people, and is known as the "king of stomach cancer" because of its high degree of malignancy. May be asymptomatic, erosions on the surface of the lesion, easy to misdiagnose and miss, and most patients are found at an advanced stage.
Early gastric cancer screening and diagnosis
In view of the current situation of the world's largest country for gastric cancer in mainland China, the mainland has specially updated and revised the Guidelines for Gastric Cancer Screening, Early Diagnosis and Treatment (2022 Edition) and the Guidelines for the Diagnosis and Treatment of Gastric Cancer (2023 Edition), suggesting that those who meet any of the 1st and 2~6 items should be listed as high-risk groups for gastric cancer and routinely screened as the screening objects. Among them, people over the age of 45 are at high risk of gastric cancer, and it is recommended to have the first examination before the age of 40, and those with family history and genetic predisposition should be preceded in advance. Especially during pregnancy, many digestive symptoms can sometimes be distinguished from morning sickness and discomfort caused by uterine elevation pressing on the stomach, and it is important to rule out tumors.
epilogue
The diagnosis and treatment of gastric cancer involves many fields of medicine, such as internal medicine, surgery, radiology, oncology, etc. Early detection and early treatment of gastric cancer are crucial for gastric cancer patients.
It is recommended that people over the age of 30 have regular medical check-ups to detect the condition as soon as possible, treat it in time, and try to avoid pain and regret.
END
Authors: Deng Zhenzhong (Xinhua Hospital, Shanghai Jiao Tong University School of Medicine)
Supervisors: Jianchun Gu, Siyu Chen (Xinhua Hospital, Shanghai Jiao Tong University School of Medicine), Zhiyong Yang (Chongming Hospital, Shanghai Health Medical College)
Review: Xu Yun, Chief Physician, Department of Oncology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Member of the Standing Committee and Secretary-General of the Cancer Rehabilitation Professional Committee of the Chinese Association of Rehabilitation Medicine
Editor: Jia Jing (Xinhua Hospital, Shanghai Jiao Tong University School of Medicine)
Follow me