gastric cancer胃癌.ppt

Gastric cancer Whats cancer？ normal cells Vs. abnormal cells Gastric cancer Here comes a patient… Examining room in USA Clinical manifestation Signs and Symptoms Early Gastric Cancer Asymptomatic or silent 80% Peptic ulcer symptoms 10% Nausea or vomiting 8% Anorexia 8% Early satiety 5% Abdominal pain 2% Gastrointestinal blood loss 2% Weight loss 2% Dysphagia 1% Signs and Symptoms Advanced Gastric Cancer Weight loss 60% Abdominal pain 50% Nausea or vomiting 30% Anorexia 30% Dysphagia 25% Gastrointestinal blood loss 20% Early satiety 20% Peptic ulcer symptoms 20% Abdominal mass or fullness 5% Asymptomatic or silent 5% Diagnosis Endoscopic image Endoscopic images Histopathology Histopathology Pathohistologic classification Histology Adenocarcinoma 90% Lymphoma 5% Stromal 2% Carcinoid 1% Metastasis 1% Adenosquamous/squamous 1% Miscellaneous 1% Radiologic diagnosis CT scan Treatment Endoscopic mucosal resection Early stage GC--EMR Open Surgery Remove the lymph nodes Laparoscopic Surgery Dr. Robot Treatment AIM OF COMBINATION THERAPY INCREASED EFFICACY The best treatment Thanks * 4th most common cancer, 930,000 cases/year 2nd most common cause of cancer death Geographic variations Geographic distribution of mortality rates f