Pathological concept of special gastric cancer

The pathological concepts of special gastric cancer are as follows:

1. Early gastric cancer The primary lesion of gastric cancer is limited to the mucosa and submucosal layer. Early gastric cancer includes: ① micro gastric cancer. CD/J, gastric cancer. ③ superficial extensive gastric cancer. ④ one-point cancer. ⑤ early gastric cancer in the residual stomach; ⑤ multiple early gastric cancer.

2. Advanced gastric cancer refers to tumors infiltrating the gastric wall muscle layer and below, which accounts for the vast majority of gastric cancers.

3. Advanced gastric cancer refers to gastric cancer that has extensively infiltrated and metastasized and cannot be cured.

Invasion and metastasis of gastric cancer

1. Direct infiltration refers to the spread of tumor cells along the interstitial space. It can infiltrate the lower esophagus upwards, the lower pylorus and the upper duodenum downwards; it can infiltrate the serosa and then invade adjacent organs such as the liver, gallbladder, pancreas, spleen, transverse colon, mesentery, peritoneum, etc., which is the main reason why tumor resection is difficult or cannot be removed.

2 Lymphatic metastasis Generally, the lymphatic metastasis of gastric cancer moves from the first station near the stomach wall to the second and third stations, and a few patients have skip metastasis. Distant lymph node metastasis of gastric cancer includes supraclavicular lymph node metastasis along the thoracic duct and a few left axillary lymph node metastasis; umbilical metastasis along the round ligament lymphatic vessels.

3. Hematogenous metastasis The most common site of hematogenous metastasis of gastric cancer is the liver, mainly through the portal vein, followed by the lungs. A small number of cases can metastasize to the pancreas, bones, brain and other parts.

4. Peritoneal implantation metastasis refers to the formation of implantation metastasis after gastric cancer cells infiltrate the serosa and fall off into the peritoneal cavity. Implantation lesions can be distributed on the surface of any organ in the abdominal cavity. The rupture of metastatic lymph nodes and the shedding of cancer cells can also cause implantation, which is called "secondary metastasis". Gastric cancer metastasis to the ovary is called Krukenerg tumor.