Ms. Liu, 36, is a housewife, who usually does not smoke or drink, and her living habits are relatively healthy.
At the end of 2019, she always felt stomach pain, and her stomach swelled after eating, "as if something was on top."
After 3 weeks of delay, in January 2020, she finally decided to go to the hospital, and the doctor recommended a painless gastroscopy.
This was her first gastroscopy, but it turned out to be like a thunderbolt on a sunny day — Ms. Liu suffered from gastric imprint cell carcinoma, locally advanced, with metastases from surrounding lymph nodes. The doctor sighed and recommended surgery as soon as possible.
When it comes to gastric ring cell carcinoma and "leather stomach", many people will think of the story of 34-year-old Internet singer Wu En.
(Source: Screenshot of Wu'en Weibo)
(Source: Wu'en Weibo screenshot) I believe that many people, in addition to sympathy and regret, are also the first time to hear such strange disease names as "leather stomach" and "seal cell carcinoma".
How dangerous is this stomach cancer, even the doctor sighs? In fact, young people especially need to take a look.
A "leather stomach" is a type of stomach cancer
The use of "leather" to describe malignant tumors of the digestive tract was first proposed in 1854 by the British surgeon William Brinton.
But leather is not only the exclusive stomach, but also "leather colon", "leather rectum", etc., as the name suggests, it is as stiff and inelastic as leather.
Leather stomach, a type of advanced stomach cancer.
This stage is generally in the middle and late stages, and is more common in men than in women.
This cancer cell growth does not bulge like a "tumor", nor does it form a deep ulcer, but diffuses and penetrates into the layers of the stomach wall.
(Bormann classification of stomach cancer, type IV is a leather stomach)
The stomach wall became thicker, harder, and gradually stiffer like leather, as if it had cultivated the "incorruptible body of King Kong".
The "small folds" (folds) on the gastric mucosa disappeared, and the stomach cavity also shrunk, so it was impossible to eat and often bloated.
In the late stage, most patients' stomachs have basically lost their peristaltic function, like a leather pocket, so it is also called "leather sac stomach".
On the pathological biopsy report of the leather stomach, the vast majority of them read "low-differentiated carcinoma", "undifferentiated carcinoma" or "seal cell carcinoma", and the degree of malignancy is very high.
What does "Seal cell carcinoma" mean?
In simple terms, this is a histological classification of gastric cancer, that is, to look at the "appearance of cancerous tissue cells" to determine the classification.
Indynosa cell carcinoma is the younger brother of the adenocarcinoma family, and other siblings include papillary, tubular, and mucosal adenocarcinomas.
Juxtaposed with the adenocarcinoma family are adenosquamous cell carcinoma, squamous cell carcinoma and undifferentiated carcinoma.
Because the cells of the seal cell carcinoma are full of mucus, the nuclei are squeezed to the side and look like a ring, hence the name.
(Microcoassm of cell carcinoma)
Cell carcinoma has a high degree of malignancy, strong invasiveness and rapid progression, and is a special type of gastric cancer.
Advanced-stage seal cell carcinoma often shows significant fibrosis or hardening, and if found later, the entire stomach may become like "leather".
Therefore, the seal ring cell carcinoma and the "leather stomach" are like a pair of difficult brothers and sisters, often appearing at the same time.
Gastric ring cell carcinoma also prefers young people, but prefers younger women. This is different from the leather stomach that is more common in men.
This may be related to the strong metabolism of estrogen in young women, and girls must pay more attention!
The "leather stomach" is cunning, good at lurking and camouflage
Although the "leather stomach" is dangerous, the symptoms are very insidious and are not easy to detect at an early stage.
In the early stages, most patients do not even have obvious symptoms, may just feel that the amount of food is small, eating is quickly full, and so on.
Some patients experience epigastric discomfort, full stomach after eating, decreased appetite, nausea, or symptoms similar to ulcer disease.
As the disease progresses, symptoms such as increased epigastric pain, weight loss, and fatigue will occur.
But unfortunately, most people wait until the stomach is very painful, the body is emaciated before going to the doctor, at this time it is found that it is already in the middle and late stages, and even lymph node metastasis has occurred.
This is also the reason why there are very few patients in the early stage of "leather stomach".
Different "leather stomachs", are there different symptoms?
Yes, that's because the tumor is located in a different location.
(Anatomical part and division of the stomach)
For example, people with lesions in the cardia and the base of the stomach (both in the upper part of the stomach) may have progressively worsening dysphagia and retrosternal pain;
People with lesions in the pylorus (lower part of the stomach) will have vomiting and lodging (vomiting out after eating for several hours);
Persistent stomach pain, supraclavicular lymphadenopathy, ascites, abdominal mass, etc., may indicate that the cancer cells have spread, which are all manifestations of the middle and advanced stages of gastric cancer.
The "leather stomach" examination methods are basically gastrointestinal angiography, gastroscopy, ultrasound, and CT.
Although many patients are found for the first time by doing gastroscopy, sometimes, gastroscopy and biopsy results can also be negative, fooling the doctor's eyes.
At this time, other tests, combined with barium tests (gastrointestinal x-ray double contrast), ultrasound, and CT, can help confirm and determine whether cancer cells have metastasized [1].
How should the "leather stomach" be treated?
Unfortunately, the "leather stomach" tends to have a short course of illness, rapid development, and poor therapeutic effects and outcomes.
The survival time is generally not more than one year, and most patients go to the hospital to see a doctor until they die, which is 3 months to half a year.
Therefore, once the diagnosis is confirmed, it is necessary to operate as soon as possible and do radical resection surgery as much as possible.
After part or the whole stomach is removed, the doctor will connect the remaining stomach, intestine, and esophagus, which is called "rebuilding the digestive tract."
(Methods of gastrointestinal reconstruction)
If the primary lesion has metastasized and cannot be removed, palliative surgery should be performed as much as possible, supplemented by chemotherapy to improve the patient's symptoms and make the tumor grow more slowly.
Of course, the doctor will treat the patient comprehensively according to the specific situation. The goal of all treatments is to slow the progression of the disease, help patients improve their quality of life, and prolong survival.
The top priority is prevention and early detection
China's stomach cancer incidence and mortality rate are among the top in the world, and there is a trend of rejuvenation, which is related to heredity, bad living habits and other factors.
If any of the following conditions are present, it may be a high-risk group for stomach cancer [2]:
In areas with a high incidence of stomach cancer (e.g., northwestern, southeastern coastal areas)
Parents, brothers and sisters and other first-degree relatives have a history of stomach cancer;
There is Helicobacter pylori infection;
Previously, there were chronic atrophic gastritis, hypertrophic gastritis, gastric polyps, gastric ulcers, pernicious anemia and other diseases;
Eating heavy taste (high-salt diet), eating pickled foods for a long time, eating too few vegetables and fruits, smoking, heavy drinking, etc.
For high-risk groups, it is recommended to have regular gastroscopy from the age of 40.
(Painless gastroscopy)
For ordinary people with low risk, it cannot be taken lightly. If you have epigastric pain, acid reflux, heartburn, nausea, dysphagia, anemia, black stools, unexplained weight loss and other symptoms, you must go gastroscopy as soon as possible!
Only early detection and early treatment can we win more survival time for ourselves.
Here, too, I would like to remind you young people, don't think that you can carry it when you are young! The crises in the body are all accumulated unconsciously.
It is precisely because you are young that you should pay more attention to healthy eating, staying away from tobacco and alcohol, regular work and rest, reasonable exercise, and regular physical examination. Only in this way can you keep cancer away from you!
bibliography:
Ye Yingjian,Tan Shiyun,Cai Ou. Diagnostic value of ultrasonic endoscopic guided fine needle aspiration biopsy in patients with gastroscopic pathology-negative leather stomach[J].Chinese Journal of Gastrointestinal Surgery,2018,21(5):578-580.
[2] Expert consensus opinion on the screening process of early gastric cancer in China (Draft, Shanghai, 2017)[J].Chinese Journal of Gastrointestinal Endoscopy, 35(2):77-88.
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