1、IntroductionDescription 概述概述Classification 分类分类Causes 病因病因Symptoms 症状症状Pathlogical Changes 病变病变Exams and Tests临床检查临床检查Treatment 治疗治疗Outlook(Prognosis)预后预后Prevention 预防预防Gastric Cancer referstocancerarisingfromanypartofthestomach.Stomachcancercausesabout800,000deathsworldwideperyear.Gastric Carcinoma
2、 isthemostcommoncauseofdeathinmalignanttumorsofalimentarysysteminChina.Description-Definitioncarcinomak:sinum n.carcinomak:sinum n.癌癌malignantmalignantmlinnt adj.mlinnt adj.恶性的恶性的alimentarylimentri adj.alimentarylimentri adj.消化的消化的Location:mainlyalongthegastriclessercurvatureside(80.3%),predominantl
3、yintheantrum(56.4%)Ahigherincidenceinmalesthanfemaleswitharatioof2:13:1.Itusuallyappearsinfourthandsixthdecadeoflife.ThisformofgastriccancerisverycommoninJapan,Chile,andIceland.Description-Features gastric lesser curvature(gastric lesser curvature(k:vt,-t k:vt,-t)side)side 胃小弯侧胃小弯侧predominantlypredo
4、minantlyprdmnntl adv.prdmnntl adv.大部分,多半大部分,多半AntrumAntrumntrm n.ntrm n.窦,腔,房窦,腔,房incidenceinsidns n.incidenceinsidns n.发病率发病率 Stomachcancerworldmap-DeathWHO(世界卫生组织)2004Age-standardised deathrates(年龄标准化死亡率)fromStomach cancerbycountry(per100,000inhabitants(居民).Description-FeaturesSeveraldifferenttype
5、sofcancercanoccurinthestomach.Themostcommontypeiscalledadenocarcinoma,whichstartsfromoneofthecommoncelltypesfoundintheliningofthestomach.Gastriccancer胃恶性肿瘤Gastriccarcinoma(Adenocarcinoma)95%(arisingfromtheepithelium来源于上皮组织)胃腺癌Gastricsarcoma5%(ArisingfromMesenchymaltissue来源于间叶组织)胃肉瘤(教材未提及)Classificat
6、ionadenocarcinomaadenocarcinomadinudinuk:sinum n.k:sinum n.腺癌腺癌the lining(the lining(衬里衬里,内层内层)of)of the stomach:the stomach:胃壁胃壁MesenchymalmesekimMesenchymalmesekiml adj.l adj.间叶细胞的间叶细胞的,间充质间充质的的Adenocarcinomaofthestomachisacommoncancerofthedigestivetractworldwide,Therateofmosttypesofgastricadenoca
7、rcinomahasgonedownovertheyears.Expertsthinkthedecreasemaybebecausepeopleareeatinglesssalted,cured,andsmokedfoods.ClassificationDigestive tractDigestive tract:消化道:消化道SaltedSalted:盐腌的:盐腌的CuredCured:熟化的,熏制的:熟化的,熏制的SmokedSmoked:烟熏过的:烟熏过的CausesYouaremorelikelytogetgastriccancerifyou:Haveafamilyhistoryofg
8、astriccancerHaveaninfectionofthestomachbybacteriacalledHelicobacter pyloriHadapolyplargerthan2centimetersinyourstomachBacteria:Bacteria:bktiri n.bktiri n.细菌细菌HelicobacterHelicobacterhelikbkt helikbkt【医医】缠绕杆菌属缠绕杆菌属 pylori pail:rai n.pylori pail:rai n.幽门幽门 -Helicobacter pylori:Helicobacter pylori:幽门螺杆
9、菌幽门螺杆菌PolypPolypplip n.plip n.息肉息肉 Haveinflammationandswellingofthestomachforalongtime(chronicatrophicgastritis)HaveperniciousanemiaSmokeCausesInflammation:Inflammation:nflmen n.nflmen n.医医 炎症炎症Swelling:Swelling:swel n.swel n.肿胀肿胀 chronic atrophicchronic atrophictrfik trfik gastritis gastritisgstrat
10、s gstrats:慢性萎缩性胃炎慢性萎缩性胃炎perniciousperniciouspns pns anemia anemiani:mi:ni:mi:恶性贫血恶性贫血Abdominalfullness(腹胀)orpain(疼痛),whichmayoccuraftereatasmallmealDarkstools(黑便)Difficultyswallowing(吞咽困难),whichbecomesworseovertimeExcessivebelching(嗳气/打嗝儿过度)Generaldeclineinhealth(全身健康机能减退)SymptomsAbdominal:Abdominal
11、:bdmnl adj.bdmnl adj.腹部的腹部的 Belch:Belch:belt v.belt v.打嗝,嗳气打嗝,嗳气Decline:Decline:diklain n.diklain n.衰退衰退 嗳嗳 i:打嗝儿,胃里的气从嘴里出来,并发出声音。打嗝儿,胃里的气从嘴里出来,并发出声音。Lossofappetite(食欲缺乏)Nausea(恶心)Vomiting,whichmaycontainblood(呕血)Weaknessorfatigue(疲劳)Weightloss(体重减轻)SymptomsAppetite:Appetite:pitait n.pitait n.胃口,食欲胃
12、口,食欲Nausea:Nausea:n:zi:,-,-si:,-n.n:zi:,-,-si:,-n.作呕;作呕;恶心;恶心;反胃反胃 Vomit:Vomit:vmit vt.&vi.vmit vt.&vi.呕吐呕吐 Fatigue:Fatigue:fti:g n.fti:g n.疲劳疲劳 Earlygastriccancer:早期胃癌Thecancerhavenotinvadedthemuscularispropria(肌层)andarethereforelimitedtothemucosa(黏膜层)andsubmucosa(黏膜下层).Advancegastriccarcinoma:进展期胃
13、癌Thecancerhaveinvadedthemuscularispropriaorevenfurtherandbeyondthemucosaandsubmucosa.Pathlogical ChangesInvadeInvade:inveid vt.&vi.:inveid vt.&vi.侵入侵入 MuscularisMuscularis:mskjulris:mskjulris肌层肌层 MucosaMucosa:mju:kus n.:mju:kus n.黏膜层黏膜层 PropriaPropria:固有层固有层 Protrudedtype(型隆起型)Superficialtype(型表浅型)S
14、uperficialelevatedtype(a型表浅隆起型)Superficialflattype(b型表浅平坦型)Superficialdepressedtype(c型表浅凹陷型)Excavatedtype(型凹陷型)Pathlogical ChangesProtrude:prtru:d vt.Protrude:prtru:d vt.使突出使突出 Superficial:sju:pfil adj.Superficial:sju:pfil adj.表面(上)的表面(上)的 Excavate:ekskvet vt.Excavate:ekskvet vt.挖掘;挖掘;开凿开凿 (1)息肉型或蕈伞
15、型polypoidorfungatingtype(2)溃疡型Ulcerativetype(3)浸润型Infiltratingtype进展期胃癌进展期胃癌大体类型大体类型 Pathlogical ChangesPolypoid:plipidPolypoid:plipid息肉样息肉样 Fungating:fngeit Fungating:fngeit 医医 真菌样生长真菌样生长 Ulcerative:lsrtiv adj.Ulcerative:lsrtiv adj.溃疡(性)的溃疡(性)的 Infiltrating:nfltret v.Infiltrating:nfltret v.(使)渗透(使)
16、渗透 Asuspiciousstomachulcerthatwasultimatelydiagnosedascanceronbiopsy(baipsi 活检)andresected(ri(:)sektid 切除).Thesurgicalspecimen(spesimn 外科手术样本)wassubsequently(sbsikwntli 随后,后来)keptforeducationalpurposes.Pathlogical ChangesAdenocarcinomaofthestomach(dinuk:sinum 腺癌)隶属溃疡型进展期胃癌,伴有溃疡形成的胃癌有时需与消化性溃疡鉴别Endosc
17、opic(endskpik 内窥镜)imageoflinitis(linaitis胃蜂窝织炎)plastica(plstik 塑料的),atypeofstomachcancerwheretheentirestomachisinvaded,leadingtoaleather(le 皮革)bottle-likeappearancewithbloodcomingoutofit.Pathlogical ChangesLinitis plastica Linitis plastica 革囊胃革囊胃 隶属浸润型进展期胃癌Diagnosisisoftendelayed(被推迟)becausesymptoms
18、maynotoccurintheearlystagesofthedisease(疾病早期阶段).Or,patientsmayself-treatsymptoms(自己治疗出现的一些症状)thatgastriccancerhasincommonwithother,lessseriousgastrointestinaldisorders(相对不那么严重的胃肠道疾病)(bloating(胃气胀),heartburn(胃灼热),andasenseoffullness(腹胀感).Exams and TestsGastrointestinalGastrointestinalgstruintestnl gs
19、truintestnl disordersdisorders胃肠道病症胃肠道病症BloatingBloatingbltblt胃气胀胃气胀HeartburnHeartburnh:tb:nh:tb:n胃灼热胃灼热Thefollowingtestscanhelpdiagnosegastriccancer:Completebloodcount(CBC)tocheckforanemiaEsophagogastroduodenoscopy(EGD)withbiopsytoexaminethestomachtissueStooltesttocheckforbloodinthestoolsExams and
20、TestsComplete blood count(CBC)to check for anemia:Complete blood count(CBC)to check for anemia:贫血时检查全血细胞计数贫血时检查全血细胞计数EsophagoEsophagoasfg asfg/gastrogastrogstr gstr/duodenoduodenodju:udi:n dju:udi:n/scopy(EGD):/scopy(EGD):食道、胃、十二指肠镜检查食道、胃、十二指肠镜检查Stool test to check for blood in the stools:Stool test
21、 to check for blood in the stools:大便中带血时检查粪便大便中带血时检查粪便Surgerytoremovethestomach(gastrectomy)istheonlytreatmentthatcancurethecondition.Radiationtherapyandchemotherapymayhelp.Formanypatients,chemotherapyandradiationtherapyaftersurgerymayimprovethechanceofacure(提高治愈的可能性).Forpatientswhocannothavesurgery
22、,chemotherapyorradiationcanimprovesymptomsandmayprolongsurvival(延长生存时间),butwilllikelynotcurethecancer.Forsomepatients,asurgicalbypassprocedure(外科旁路手术)mayrelievesymptoms(减轻症状).TreatmentGastrectomy:Gastrectomy:strektmi strektmi 胃切除术胃切除术RadiationRadiationreidiein reidiein therapy:therapy:放疗放疗Chemothera
23、pyChemotherapykemuerpi kemuerpi:化疗化疗Theoutlookvaries(预后情况).Tumorsinthelowerstomach(胃下部的肿瘤)arecuredmoreoftenthanthoseinthehigherstomach-gastriccardia(胃贲门)orgastroesophagealjunction(食管胃连接).Howfarthetumorinvadesthestomachwall(肿瘤侵袭胃壁的程度)andwhetherlymphnodes(淋巴结)areinvolved(是否已发生淋巴道转移)whenthepatientisdia
24、gnosedaffectthechancesofacure(影响治愈的可能性).Whenthetumorhasspreadoutsidethestomach(肿瘤已经扩散到胃外时),acureisnotpossible(治愈已经不可能了)andthegoaloftreatmentistoimprovesymptoms(使症状好转).Outlook(Prognosis)gastric cardiagastric cardiak:di k:di 胃贲门胃贲门GastroesophagealGastroesophagealstruisfdi:l struisfdi:l 食管胃的食管胃的lymphly
25、mphlmf lmf nodes nodesnudz nudz 淋巴结淋巴结Mass screening programs(疾病普查程序疾病普查程序)havebeensuccessfulatdetectingdiseaseintheearlystages(疾病早期探测)inJapan,wheretheriskofgastriccancer(胃癌带来的危害)ismuchhigherthanintheUnitedStates.Thevalueofscreening(这种普查的价值)intheUnitedStatesandothercountrieswithlowerratesofgastricca
26、ncer(美国以及胃癌发病率较低的其它国家)isnotclear(尚不明确).PreventionThe following may help reduce your risk of gastric cancer:DontsmokeEatahealthy,balanceddietrichinfruitsandvegetablesTakeamedicationtotreatrefluxdisease,ifyouhaveitPreventionrefluxrefluxri:flks ri:flks disease:disease:胃食管反流病胃食管反流病(简称(简称GERDGERD)是指胃)是指胃 十二指肠内容物反十二指肠内容物反流入食管引起的以烧心流入食管引起的以烧心 反酸为主要特征的临床综合征反酸为主要特征的临床综合征