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IntroductionDescription概述Classification分类Causes病因Symptoms症状PathlogicalChanges病变ExamsandTests临床检查Treatment治疗Outlook(Prognosis)预后Prevention预防•GastricCancerreferstocancerarisingfromanypartofthestomach.Stomachcancercausesabout800,000deathsworldwideperyear.•GastricCarcinomaisthemostcommoncauseofdeathinmalignanttumorsofalimentarysysteminChina.Description--Definitioncarcinoma[ˌkɑ:siˈnəumə]n.癌malignant[məˈliɡnənt]adj.恶性的alimentary[ˌæliˈmentəri]adj.消化的•Location:mainlyalongthegastriclessercurvatureside(80.3%),predominantlyintheantrum(56.4%)•Ahigherincidenceinmalesthanfemaleswitharatioof2:1~3:1.•Itusuallyappearsinfourthandsixthdecadeoflife.•ThisformofgastriccancerisverycommoninJapan,Chile,andIceland.Description--Featuresgastriclessercurvature([ˈkɜ:vəˌtʃʊə,-tʃə])side胃小弯侧predominantly[prɪˈdɔmɪnəntlɪ]adv.大部分，多半Antrum[ˈæntrəm]n.窦，腔，房incidence[ˈinsidəns]n.发病率Stomachcancerworldmap-Death–WHO(世界卫生组织)2004Age-standardiseddeathrates(年龄标准化死亡率)fromStomachcancerbycountry(per100,000inhabitants(居民)).Description--Features•Severaldifferenttypesofcancercanoccurinthestomach.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）Classificationadenocarcinoma[ˈædinəuˌkɑ:siˈnəumə]n.腺癌thelining(衬里,内层)ofthestomach:胃壁Mesenchymal[mes‘eŋkiməl]adj.间叶细胞的,间充质的•Adenocarcinomaofthestomachisacommoncancerofthedigestivetractworldwide,Therateofmosttypesofgastricadenocarcinomahasgonedownovertheyears.Expertsthinkthedecreasemaybebecausepeopleareeatinglesssalted,cured,andsmokedfoods.ClassificationDigestivetract：消化道Salted：盐腌的Cured：熟化的，熏制的Smoked：烟熏过的CausesYouaremorelikelytogetgastriccancerifyou:•Haveafamilyhistoryofgastriccancer•HaveaninfectionofthestomachbybacteriacalledHelicobacterpylori•Hadapolyplargerthan2centimetersinyourstomachBacteria:[bæk'tiəriə]n.细菌Helicobacter[ˈhelikɔbæktə]【医】缠绕杆菌属pylori[paiˈlɔ:rai]n.幽门--Helicobacterpylori:幽门螺杆菌Polyp[ˈpɔlip]n.息肉•Haveinflammationandswellingofthestomachforalongtime(chronicatrophicgastritis)•Haveperniciousanemia•SmokeCausesInflammation:[ˌɪnfləˈmeɪʃən]n.[医]炎症Swelling:[ˈswelɪŋ]n.肿胀chronicatrophic[əˈtrɔfik]gastritis[gæˈstraɪtɪs]:慢性萎缩性胃炎pernicious[pəˈnɪʃəs]anemia[əˈni:mi:ə]:恶性贫血•Abdominalfullness(腹胀)orpain(疼痛),whichmayoccuraftereatasmallmeal•Darkstools(黑便)•Difficultyswallowing(吞咽困难),whichbecomesworseovertime•Excessivebelching(嗳气/打嗝儿过度)•Generaldeclineinhealth(全身健康机能减退)SymptomsAbdominal:[æbˈdɔmənəl]adj.腹部的Belch:[beltʃ]v.打嗝，嗳气Decline:[diˈklain]n.衰退嗳[ǎi]: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:[ˈæpitait]n.胃口，食欲Nausea:[ˈnɔ:zi:ə,-ʒə,-si:ə,-ʃə]n.作呕；恶心；反胃Vomit:[ˈvɔmit]vt.&vi.呕吐Fatigue:[fə'ti:g]n.疲劳Earlygastriccancer:早期胃癌•Thecancerhavenotinvadedthemuscularispropria(肌层)andarethereforelimitedtothemucosa(黏膜层)andsubmucosa(黏膜下层).Advancegastriccarcinoma:进展期胃癌•Thecancerhaveinvadedthemuscularispropriaorevenfurtherandbeyondthemucosaandsubmucosa.PathlogicalChangesInvade:[inˈveid]vt.&vi.侵入Muscularis:[mʌskjuˈlɛəris]肌层Mucosa:[mju:ˈkəusə]n.黏膜层Propria:固有层Protrudedtype(Ⅰ型隆起型)Superficialtype(Ⅱ型表浅型)•Superficialelevatedtype(Ⅱa型表浅隆起型)•Superficialflattype(Ⅱb型表浅平坦型)•Superficialdepressedtype(Ⅱc型表浅凹陷型)Excavatedtype(Ⅲ型凹陷型)PathlogicalChangesProtrude:[prəʊˈtru:d]vt.使突出Superficial:[ˌsju:pəˈfiʃəl]adj.表面（上）的Excavate:[ˈekskəˌveɪt]vt.挖掘；开凿(1)息肉型或蕈伞型polypoidorfungatingtype(2)溃疡型Ulcerativetype(3)浸润型Infiltratingtype进展期胃癌大体类型PathlogicalChangesPolypoid:['pɔlipɔid]息肉样Fungating:['fʌngeit][医]真菌样生长Ulcerative:[ˈʌlsərətiv]adj.溃疡（性）的Infiltrating:[ɪnˈfɪlˌtreɪtɪŋ]v.（使）渗透Asuspiciousstomachulcerthatwasultimatelydiagnosedascanceronbiopsy([baiˈɔpsi]活检)andresected([ri(:)ˈsektid]切除).Thesurgicalspecimen([‘spesimən]外科手术样本)wassubsequently([’sʌbsikwəntli]随后，后来)keptforeducationalpurposes.PathlogicalChangesAdenocarcinomaofthestomach([‘ædinəukɑ:si’nəumə]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Endoscopic([endɔs‘kɔpik]内窥镜)imageoflinitis([li‘naitis]胃蜂窝织炎)plastica([ˈplæstikɑ]塑料的),atypeofstomachcancerwheretheentirestomachisinvaded,leadingtoaleather([ˈleðə]皮革)bottle-likeappearancewithbloodcomingoutofit.PathlogicalChangesLinitisplastica革囊胃隶属浸润型进展期胃癌Diagnosisisoftendelayed(被推迟)becausesymptomsmaynotoccurintheearlystagesofthedisease(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)).ExamsandTestsGastrointestinal[gæstrəuin'testənl]disorders胃肠道病症Bloating[bləʊtɪŋ]胃气胀Heartburn[ˈhɑ:tbə:n]胃灼热Thefollowingtestscanhelpdiagnosegastriccancer:•Completebloodcount(CBC)tocheckforanemia•Esophagogastroduodenoscopy(EGD)withbiopsytoexaminethestomachtissue•StooltesttocheckforbloodinthestoolsExamsandTestsCompletebloodcount(CBC)tocheckforanemia:贫血时检查全血细胞计数Esophago[aɪˈsɔfəgəʊ]/gastro[ˈgæstrəʊ]/duodeno[ˌdju:əuˈdi:nəʊ]/scopy(EGD):食道、胃、十二指肠镜检查Stooltesttocheckforbloodinth