How did gastric cancer come about?

Gastric cancer is a malignant tumor originating from the gastric mucosal epithelium, accounting for 95% of gastric malignant tumors. The proportion of human tumors varies with different regions, generally about 10 to 30%. Gastric cancer can be seen It is a common disease that threatens human health. [Cause]: The cause of gastric cancer has not yet been fully elucidated. Through research on the geographical distribution of gastric cancer incidence and its relationship with immigration, it is generally believed that external environment and dietary factors are most closely related to the occurrence of gastric cancer. The human body also has certain conditions that are conducive to the occurrence of gastric cancer, which cannot be ignored. (1) Genetic factors: Clinicians have all encountered situations where more than two members of a family suffer from gastric cancer. Although this tendency to develop gastric cancer is very rare, it at least suggests the possibility of genetic factors. There are reports that the incidence rate of gastric cancer among relatives of gastric cancer patients is 4 times higher than that in the control group. Among genetic factors, many authors have noticed the relationship between blood type. According to some statistics, the incidence of gastric cancer in type A people is 20% higher than that of people with other blood types. However, there are also some reports that there is no difference in the incidence of gastric cancer among people with different blood types. In recent years, some people have studied the relationship between the incidence of gastric cancer and HLA, but further conclusions need to be made. (2) Geographical and environmental factors Surveys on the epidemiology of gastric cancer in various countries around the world have shown that there are significant differences in the incidence rates of gastric cancer in different regions and ethnic groups. These differences may be related to genetic and environmental factors. Some data indicate that gastric cancer occurs more frequently in high latitude areas. The farther a country is from the equator, the higher the incidence rate of gastric cancer. There is also information that its incidence is related to coastal factors. There are factors here of different dietary habits, but also geochemical factors and the possibility of carcinogens in the environment should be considered. The National Gastric Cancer Comprehensive Survey Epidemiology Team has investigated areas with high incidence of gastric cancer in China, such as the Hexi Corridor of the inner river system of the Qilian Mountains, the upper reaches of the Yellow River, the lower reaches of the Yangtze River, the mouth of the Minjiang River, the lower reaches of Mulan Creek and the southern section of the Taihang Mountains. It was found that except for the southern section of the Taihang Mountains, Except for metamorphic rocks, the rest are volcanic rocks and high peat, with deep and large faults locally or on one side. The Ca/SO4 ratio in the water is small, but the nickel, selenium and cobalt contents are high. The inspection team also investigated areas with low incidence of gastric cancer, such as the upper reaches of the Yangtze River and the Pearl River system, and found that the area is a limestone zone with no deep faults, a large Ca/SO4 ratio in the water, and low nickel, selenium and cobalt contents. It is known that volcanic rocks contain 3,4 benzopyrene, some of which are as high as 5.4-6.1 μg/kg. The content of nitrosamine precursors such as organic nitrogen in peat is high, making the gastric mucosa prone to damage. In addition, selenium and cobalt can cause gastric damage, and nickel can promote the carcinogenic effects of 3,4 benzopyrene. Whether the above geographical environmental factors are the reasons for the formation of these high-incidence areas of gastric cancer in China deserves further exploration. (3) Dietary factors The influence of dietary factors on the incidence of gastric cancer has attracted the attention of cancer researchers in various countries. Possible dietary carcinogens include regular consumption of smoked and grilled foods (containing benzopyrene) or pickled foods and sauerkraut (containing N-nitroso compounds). Research in recent years has proposed protective factors, such as milk, animal protein, fresh vegetables and some fruits. Recent declines in gastric cancer rates in Japan and the United States have been attributed to improved diet. However, research on the relationship between diet and tumors and their carcinogenic mechanisms is extremely complex. There may be carcinogens that play a direct role in food, whether they exist naturally or are produced during food cooking, processing, and storage. Carcinogens may also be formed under the action of some factors in the body after food is ingested into the human body. In the process of carcinogenesis, some substances play the role of initiating carcinogens, and some play the role of promoting or suppressing cancer. They are also intertwined with the complex metabolism and biological transformation processes in the human body. Therefore, it is difficult to separate these complex A definite connection was found among the factors. Experimental data can be used to evaluate the role of dietary and metabolic factors in human gastric carcinogenesis, and the results are only convincing if they are consistent with epidemiological evidence. The survey results of the my country Gastric Cancer Comprehensive Survey Epidemiology Group on areas with high and low incidence of gastric cancer in China show that gastric cancer is closely related to diet. Gastric adenocarcinoma has been seen in experiments involving sterigmatoxin-induced liver cancer in rats. Fungi such as Aspergillus versicolor and Aspergillus nidulans can be detected from the main and non-staple foods in the survey area and the gastric juice of patients. The detection rate in areas with high incidence of gastric cancer is obviously higher than that in areas with low incidence, which can indicate that moldy food is a risk related to gastric cancer. factor. Salted foods high in salt are considered another risk factor for gastric cancer. Residents in areas with a high incidence of gastric cancer in my country consume more than 9kg of salt per person per year, while those in areas with a low incidence of gastric cancer range from 4 to 7.5kg.

The comparative survey also found that areas with a high incidence of gastric cancer have a variety of simple foods, while areas with a low incidence have a variety of non-staple foods and a higher intake of fresh vegetables, beans and animal protein. This may indicate that gastric cancer is related to an imbalance of nutrients. In addition, survey statistics suggest that fresh vegetable consumption is negatively correlated with gastric cancer-adjusted mortality, and fresh vegetables can be considered a protective factor. Fresh vegetables are rich in vitamins A, C and minerals. Vitamin A is related to epithelial regeneration and maintaining its normal function. Vitamin C can block the synthesis of nitroso compounds by nitrite and secondary amines in the stomach. It has been confirmed that iron deficiency is related to Plummer-Vinson syndrome, which is related to the occurrence of esophageal and gastric cancer. Therefore, iron deficiency is indirectly related to the occurrence of gastric cancer. (4) Other disease factors 1. Gastric Ulcer There has always been a debate about whether gastric ulcer can become cancerous. Many people believe that the occurrence of most cancers has nothing to do with ulcers. However, it can be seen from clinical or pathological studies that there is a certain relationship between gastric ulcer and the occurrence of gastric cancer. Domestic reports indicate that the canceration rate of gastric ulcers is 5 to 10%. In particular, patients with a long history of gastric ulcers and middle-aged and older patients have a greater chance of developing cancer. The mucosal epithelium or glands at the edge of the ulcer are eroded by gastric juice, causing erosion. Transform into cancer under chronic stimulation of repeated destruction and regeneration. The incidence of residual gastric cancer after subtotal gastrectomy is much higher than that in the general population, and it has recently attracted the attention of clinical workers. 2. Chronic gastritis According to the mucosal morphology seen on fiberoptic gastroscopy, chronic gastritis can be divided into three types: superficial, atrophic and hypertrophic. It is now recognized that atrophic gastritis is a precursor to gastric cancer, especially when it coexists with gastric polyps or intestinal metaplasia. Superficial gastritis can be cured, but it may gradually transform into atrophic gastritis. Hypertrophic gastritis is not closely related to the incidence of gastric cancer. Atrophic gastritis is difficult to cure, and its tissues tend to regenerate, sometimes forming polyps, and sometimes becoming cancerous. Long-term follow-up can reveal that about 10% of patients with atrophic gastritis develop cancer. Data from a national comprehensive survey of gastric cancer show that there are significantly more cases of superficial and atrophic gastritis in areas with a high incidence of gastric cancer than in areas with a low incidence of gastric cancer. Analysis of fasting gastric juice of patients with chronic gastritis in high-incidence areas showed that the free acid content was reduced, and the pH value, bacterial count, NO2 content, and nitrate-reducing bacteria detection rate were all increased, which was significantly different from those in low-incidence areas. The above-mentioned degree of changes in the gastric environment is positively correlated with the severity of chronic gastritis lesions, which also shows that changes in the gastric environment in patients with chronic gastritis are very conducive to the synthesis of N-nitroso compounds. 3. Gastric Polyps Any benign gastric tumor has the possibility of malignant transformation, but epithelial adenomas or polyps have a greater chance of malignant transformation. The incidence of cancer increases in polyps larger than 2cm in diameter. It has been reported that 20% of patients diagnosed with gastric polyps by It means that all cases diagnosed as gastric polyps by X-ray should not be let go easily. 4. Intestinal metaplasia of the gastric mucosa refers to the transformation of the intrinsic mucosal epithelium of the stomach into small intestinal epithelial cells. In mild cases, there are only a few intestinal epithelial cells in the pylorus. In severe cases, the invasion range is widespread, and the entire mucosa becomes thickened, even in the gastric body. There is also the formation of intestinal pseudovilli. The lesions of intestinal gland metaplasia may represent atypical hyperplasia (also known as anaplasia) caused by harmful substances irritating the gastric mucosa. If the irritation persists, the metaplastic state may also continue to exist; with appropriate treatment, the metaplastic state can return to normal or disappear completely. Therefore, mild gastric mucosal intestinal metaplasia cannot be regarded as a precancerous lesion. Sometimes the metaplastic intestinal gland epithelial hyperplasia changes beyond normal limits. When the atypical hyperplasia of this aberrant epithelium develops seriously, such as grade III anaplasia, it can be regarded as a precancerous lesion. [Clinical symptoms]: Early gastric cancer is often asymptomatic or has only mild symptoms. When clinical symptoms are obvious, the disease is already in an advanced stage. Therefore, we should be very vigilant about the early symptoms of gastric cancer to avoid delays in diagnosis and treatment. (1) Early manifestations: Upper abdominal discomfort is the most common initial symptom of gastric cancer. About 80% of patients have this symptom, which is similar to indigestion. If abdominal pain occurs, it is generally mild and irregular, and cannot be relieved after eating. These symptoms are often not taken seriously by patients, and are easily mistaken for gastritis or ulcer disease when seeking medical treatment. Therefore, if middle-aged patients have the following conditions, they should be given further examination to avoid missed diagnosis: ① There is no history of gastric disease in the past, but they have recently experienced unexplained upper abdominal discomfort or pain, which is ineffective after treatment; ② They have a past history of gastric ulcer and recent upper abdominal pain. The patterns are changing and the severity is getting worse day by day.

If the symptoms are relieved but relapse in a short period of time, the possibility of gastric cancer should also be considered and further examinations should be carried out in a timely manner. Nearly 50% of gastric cancer patients have obvious symptoms of loss of appetite or loss of appetite. Some patients limit their food intake because eating too much can cause abdominal bloating or abdominal pain. Unexplained anorexia and weight loss are likely to be the initial symptoms of early gastric cancer and require attention. Patients with early gastric cancer generally have no obvious positive signs. In addition to weak general condition, most patients only experience deep tenderness in the upper abdomen. (2) Late manifestations: When gastric cancer develops and expands, especially when it infiltrates through the serosa and invades the pancreas, persistent severe pain may occur and radiate to the lower back. The absorption of cancer toxins can cause patients to become increasingly thin, fatigued, anemic, and finally manifest as cachexia. As the cancer grows larger, symptoms of obstruction may appear. Cancer of the cardia or fundus of the stomach may cause dysphagia, and cancer of the gastric antrum may cause symptoms of pyloric obstruction. A mass may also be palpable in the abdomen. When ulcers form on the surface of the cancer, hematemesis and melena may occur. As for the appearance of metastasis and ascites, it is the most common symptom of advanced gastric cancer. [Treatment method]: Soothe the liver and stomach, strengthen the spleen, and nourish yin. Agarwood 10, Fa Xia 12, Scutellaria barbata 15, Cyperus rotundus 10, Yunling 15, Atractylodes 15, Northern Adenophora 15, Amomum villosum 9, Lycium barbarum 12, Ten Great Merit Leaves 15, Ligusticum chuanxiong. 9 White peony root 12 Anemarrhena 12 Shanzi mushroom 12 Lithospermum 10 Phellodendron 10 [Additional and subtractive]: (1) For those with poor appetite, add Gallus gallus gallus 12, Hawthorn 10 Divine Comedy 10 Codonopsis pilosula 12 (2) For constipation, add Cistanche deserticola 12 and some honey (take separately) (3) For those with blood in the stool, add 12 pieces of blood residual charcoal, 12 pieces of bletilla striata, 15 pieces of agrimony, 10 pieces of donkey-hide gelatin (yanghua)