Early gastric cancer is mostly asymptomatic or has only mild symptoms. When the clinical symptoms are obvious, the lesion is already in the advanced stage. Therefore, we should be very alert to the early symptoms of gastric cancer so as not to delay the diagnosis and treatment of 1. Symptoms (1) Early gastric cancer: With the development of the disease, the function and general condition of the stomach gradually change, and these symptoms are often non-specific, which can be hidden from time to time or exist for a long time. Such as epigastric pain, dull pain, dull pain, nausea, loss of appetite, belching and emaciation; A few early gastric cancers with ulcer type (type ⅱ C and type ⅲ) can also have ulcer-like symptoms, such as rhythmic pain and acid regurgitation, which can be relieved by medical treatment. Some patients' gastric cancer coexists with some benign lesions or becomes cancerous on the basis of some benign lesions (such as chronic atrophic gastritis, peptic ulcer, etc. ), and the symptoms of these benign gastric diseases persist or recur for a long time, which makes it easier for patients and doctors to relax their vigilance against gastric cancer and delay the diagnosis opportunity. Some early gastric cancer may also have symptoms such as vomiting blood, black stool or dysphagia. ① Upper abdominal discomfort: it is the most common first symptom in gastric cancer, and about 80% patients have this manifestation, which is similar to indigestion. If abdominal pain occurs, it generally starts to be slightly irregular, can not be relieved after eating, and gradually increases, which can be dull pain or dull pain. Some of them may have rhythmic pain, especially gastric antrum cancer, which can even be relieved by eating or taking medicine. Old people have dull pain and complain of abdominal distension. These symptoms are often ignored by patients and easily mistaken for gastritis or ulcer when seeking medical treatment. Therefore, middle-aged patients should be further examined if they have the following conditions, so as to avoid missed diagnosis: a. They have no history of stomach trouble in the past, but have recently developed upper abdominal discomfort or unexplained pain, which is ineffective after treatment; B. Past history of gastric ulcer, recent upper abdominal pain has regular changes, and the degree is aggravated. If the symptoms are relieved, but there is an author in the short term, we should also consider the possibility of gastric cancer and do further examination in time. ② Loss of appetite or loss of appetite: Loss of appetite and emaciation are the second common symptoms of gastric cancer. Nearly 50% patients with gastric cancer have obvious symptoms of loss of appetite or loss of appetite, and some patients restrict their eating because eating too much will cause abdominal distension or abdominal pain. Unexplained anorexia and emaciation are probably the initial symptoms of early gastric cancer and need to be paid attention to. Patients with early gastric cancer generally have no obvious positive signs, and most of them only have deep tenderness in the upper abdomen except for weak general condition. (2) Advanced gastric cancer: The pathological change of gastric cancer is a gradual process from small to large, from shallow to deep, from no metastasis to metastasis, so there is no obvious boundary between early, late and even late stages. And the symptoms of each stage often overlap greatly. Some patients have advanced lesions, but the symptoms are not obvious. Although some patients are in the early stage, their symptoms are outstanding, and some patients have symptoms of organ metastasis or complications during treatment. According to domestic statistics, the common symptoms of advanced gastric cancer are: ① Abdominal pain: when gastric cancer develops and expands, especially when it infiltrates and penetrates serosa, invading pancreas or transverse mesocolon, persistent severe pain may appear and radiate to the back. A very small number of patients with perforation of cancerous ulcer may also have abdominal pain and peritoneal irritation. ② Loss of appetite and emaciation: The absorption of cancer toxin can make patients emaciated day by day, fatigue, anemia, malnutrition, often progressive aggravation, and finally cachexia. ③ Nausea and vomiting: It is also one of the more common symptoms, which can appear early. Gastric antrum cancer can also have symptoms of pyloric obstruction. (4) Hematemesis and melena: When an ulcer forms on the cancer surface, hematemesis and melena appear. 1/3 patients with gastric cancer often have a small amount of bleeding, most of them are positive for occult blood in stool, some may have intermittent melena, but some have a lot of hematemesis. ⑤ Diarrhea: It may be related to low gastric acid, and the stool is mushy and even diarrhea. Late gastric cancer involving colon can often cause diarrhea and bloody stool. ⑥ Dysphagia: When cancer grows up, it may cause obstruction symptoms, cardiac cancer or fundus cancer may cause dysphagia, and gastric antrum cancer may cause pyloric obstruction symptoms. 2. Early gastric cancer may have no symptoms. Or just tenderness in the upper abdomen. Most patients with advanced gastric cancer have obvious upper abdominal tenderness. 13 patients have palpable masses in the abdomen, which are hard, uneven and tender, especially the emaciated patients with gastric antrum cancer. As for metastatic lesions such as palpable mass of rectum, umbilical mass, supraclavicular lymph node enlargement and ascites, it is more evidence of advanced gastric cancer. Upper abdominal mass, anterior rectal recess mass, umbilical mass, left supraclavicular lymph node enlargement, left axillary lymph node enlargement, ascites, etc. Usually indicates distant metastasis. Due to different metastatic sites, corresponding signs often appear, which makes the clinical manifestations very complicated. For example, liver metastasis can lead to hepatomegaly and jaundice, ovarian metastasis can lead to ovarian enlargement and a lot of ascites, and lung metastasis can lead to dyspnea. In addition, gastric cancer with cancer syndrome can also become an important sign, such as thrombophlebitis and dermatomyositis. Advanced patients may have fever and cachexia.