"Hello Dr. Li. Gastric cancer T3N0M0 has a medium-low differentiation. Is it serious? Six stages of postoperative chemotherapy", this is the content of a netizen's question. Next, I will talk about my own opinions on the patient's questions
First, I will share with netizens the disease knowledge about gastric cancer T3N0M0
gastric cancer T3N0M0, indicating the pathological staging of patients with gastric cancer after surgery. Currently, the staging of gastric cancer disease is evaluated. On pathology , TNM staging is usually used:
T staging mainly refers to the degree of tumor invasion, and T3 staging of gastric cancer refers to the cancer cells of gastric cancer that have penetrated the connective tissue under the serous membrane without invading the visceral peritoneum or adjacent structures. Here, I would like to remind all netizens that this T3-stage gastric cancer patient has actually destroyed the blood vessels and lymphatic vessels located in the stomach wall. In theory, gastric cancer cells have the opportunity to enter the patient's blood vessels and lymphatic vessels, which also provides the risk of onset for the patient's later recurrence of gastric cancer. This is also the reason why postoperative chemotherapy is required for this pathological type of postoperative patients, as well as clinical guidelines for gastric cancer tumors at home and abroad.
gastric cancer
N stage mainly refers to the metastasis of lymph node . N0 stage reminds patients that no lymph node metastasis was found in pathological examinations from pathological samples. What I want to remind netizens here is that patients with T3 gastric cancer stage have a low risk of lymphatic metastasis, but not absolutely nothing!
M installment refers to whether there is a distant metastasis. The current imaging and pathological examination of M0 refers to no distant metastasis found. However, due to T3 gastric cancer staging patients, their gastric cancer cells have invaded the microvessels of the stomach wall. According to current clinical studies, this type of T3 gastric cancer staging patients have a low risk of distant blood metastasis, but it cannot be ruled out!
Then shared relevant knowledge about gastric cancer cells with netizens.
Low differentiation in gastric cancer refers to the classification of pathological tissue cells of gastric cancer. The medium and low differentiation of gastric adenocarcinoma means that the patient suffers from gastric adenocarcinoma, and the degree of differentiation of cancer cells is low or medium differentiation.
Gastric adenocarcinoma is a malignant tumor originating from the epithelial cells of the gastric mucosal glands. According to the similarity between cancer cells and normal epithelial cells, it is divided into highly differentiated adenocarcinoma, medium differentiated adenocarcinoma, low differentiated adenocarcinoma, and undifferentiated adenocarcinoma. The degree of differentiation is located in the part of medium and low differentiated adenocarcinoma, which is called medium and low differentiated adenocarcinoma.
gastric cancer
Medium and low differentiation adenocarcinoma means that the biological characteristics of cancer cells and normal cells are far different. The tissue is severely destructive, has a high degree of malignancy, is prone to metastasis in the early stage, and has a poor prognosis. Once the patient diagnosed after surgery is T3N0M0 medium and low differentiated gastric adenocarcinoma, standardized and effective chemotherapy is needed as soon as possible to improve the efficacy of postoperative patients.
For patients with T3 stage gastric cancer, I would like to remind you here that due to the long course of the disease, gastric cancer cells are greatly affected by environmental factors, and often have heterogeneous characteristics of gastric cancer cells. In other words, patients mainly use medium and low differentiated gastric cancer cells, but there is also the possibility of other gastric cancer cells different from each other. In addition, with the changes in the internal environment brought about by treatments such as surgery and chemotherapy, heterogeneous changes in gastric cancer cells will also occur. This is also the root cause of the difficulty in curing gastric cancer.
Finally, let’s analyze the disease status of this T3N0M0 medium and low differentiated gastric cancer patient.
gastric cancer
From the above-mentioned knowledge of the pathological staging and pathological tissue cells of gastric cancer, we know that this gastric cancer patient is a progressive gastric cancer with a risk of lymph and blood metastasis. The patient performed 6 chemotherapy sessions after the operation, which shows that the patient's attending physician has taken into account the severity of the patient's disease and has also promptly conducted standardized treatment according to the clinical guidelines for gastric cancer. Here, I would like to remind the patients of the following two aspects:
If you do not have the risk of gastric cancer recurrence after postoperative chemotherapy, it means: First, the patient's gastric cancer may not have lymph and blood metastasis. A purely radical surgery for gastric cancer can achieve the purpose of curing gastric cancer.Second, although the patient's gastric cancer has lymph and blood metastasis factors, standardized postoperative chemotherapy eliminates these risk factors in a timely manner, thereby avoiding the recurrence of gastric cancer.
If you still have recurrence and metastasis of gastric cancer after postoperative chemotherapy, it means that the patient's preoperative and postoperative pathological staging are both wrong. Of course, the reason for this error is caused by the limitations of current medical science and technology, not the doctor's fault. In addition, your postoperative chemotherapy treatment has not really eliminated and controlled the progression of gastric cancer. Such treatment difficulties often occur due to heterogeneous changes in gastric cancer. To reduce the harm of this gastric cancer: First, follow-up and examination work after surgery is achieved in a timely manner. Second, if necessary, re-examine the pathological histocellular examination of cancer cells in order to prescribe the right medicine and improve the treatment effect of gastric cancer.
