Many people have had their stomach glasses and pathological examinations and have been given reports with a mist, with such specialized terms as “low-distorted gland cancer” “pt1n0m0” and “upper-skin membrane tumors” on them, which make people blind. In fact, pathological reporting and phasing is the central basis for determining the severity of stomach cancer and developing treatment programmes. Today, we interpret these professional terms in common language, helping to understand the report and our own situation。
First, we say pathology, which is the “final criterion” for the diagnosis of stomach cancer. Pathological examination is the tissue that removes the stomach lens, which is observed under the microscope and determines the form and nature of the cell. The two most critical messages are “organizational grade” and “organizational grade”。
In tissue grade, the most common is “gland cancer”, which accounts for the vast majority of stomach cancer, most of which we call stomach cancer. Added to this are the types of breast cancer, mucous gland cancer, imprint cell cancer, among which the degree of virulence is relatively high and treatment is more difficult. In addition, the pathological report refers to the “laurén spectra”, which is divided into enteric, permeable, mixed, gastrointestinal cancers with relatively good prognosis and permeability。
Organizational classification, in short, the determination of the “odiousness” of cancer cells, divided into high, medium and low. The form of high-divisive cancer cells and normal gastric mucous membrane cells are relatively close, growth is slow, malignity is low and prognosis is better; the morphology and normality of low-divisive cancer cells vary widely, growth speed is rapid, malignantity is high, transferable is easy and the prognosis is relatively different; and the modulation is in between. For example, “low-distorted gland cancer” as described in the report means that cancer cells are more malignant and require more active treatment。
Next, we focus on the stagening of stomach cancer, which is one of the most important concerns. At present, the tnm phase standards, developed jointly by ajcc/uicc, are widely used in medicine, in which t represents the immersion depth of the original tumour, n represents the regional lymphoma transfer, and m represents the long-range transfer, and through these three indicators, it is possible to determine the stage of stomach cancer, divided into i, ii, iii and iv periods, the smaller the number, the lighter the condition, the better。
First, the t-phase, which describes the depth of the tumour attack on the stomach wall: t-1 is the mucous membrane or the lower membrane zone of the tumour attack on the stomach, which we referred to in the previous issue; t2 is the tumour attack on the inherent muscle layer of the stomach; t3 is the tumultular conjunction tissue of the tumour through the stomach wall, but it has not yet been violated to the ecstasy; t4 is the tumour attack on the membrane or on the adjacent organs around the stomach, such as the liver, pancreas, spleen, etc., which is in the late stages of progress。
When looking at the n-phase, it describes the movement of lymph nodes around the stomach area: the n-0 period is no lymph nodes transfer; the n1 period is 1-2 regional lymph nodes transfer; the n2 period is 3-6 regional lymph nodes transfer; and the n3 period is 7 and more regional lymph nodes transfer, with the more lymph nodes transferred and the more serious the condition. It is a reminder that early stomach cancer may also have lymphoma transfer, although the probability is relatively low。
Finally, the m-phase is used to determine whether there is a long-range transfer: the m-0 period is not a long-range transfer; the m1 period is a long-range transfer, such as liver transfer, lung transfer, abdominal transfer, bone transfer, etc., and if there is a long-range transfer, it is a iv-stage stomach cancer, i. E. A late-stage stomach cancer。
For example, the “pt1n0m0” in the report, i. E. The pathology phase i, means that the tumors are invasive to the mucous membrane or the lower membrane, without lymphoma transfer and no remote transfer, which is the early stage of stomach cancer, with the best treatment, and can be achieved through an endoscope operation or a small scale operation. However, “pt4n2m1” is stage iv stomach cancer, neoplasms to neighbouring organs, 3-6 lymph nodes transfer, and long-range transfer, requiring comprehensive treatment to extend life。
In addition, the pathology report refers to “upper-skinneoma change”, which is a pre-cancer pathology of stomach cancer, with low and high levels. Low-level upper-skinned cancers, which are equivalent to mild, moderate and non-typical growth, are mostly reversible through active treatment, such as eradication of cholesteroccus, periodic review, and do not develop into stomach cancer; high-level upper-skinned cancers, which are equivalent to abnormality of gravity, are at high risk of cancer and usually require timely surgical removal to prevent their development into stomach cancer。
The understanding of pathological reports and stages helps to better communicate with doctors and to learn about their severity, treatment and prognosis. There is no need to panic about seeing the word “cancer”, and early stomach cancer is cured at a very high rate, and even mid- and late-stage stomach cancer, through standardized treatment, can effectively prolong life and improve the quality of life。
In the next issue, we will talk about treatments for stomach cancer, including endoscopy treatment, surgical treatment, chemotherapy, targeting treatment, etc., to help you understand the application of different treatments and to combat fear of treatment。
