Gastrointestinal cancer syndrome

　　The most typical in gastrointestinal cancer syndrome is protein-losing gastrointestinal disease. Physiological research has confirmed that only about 10% of the degradation products of plasma albumin and globulin are excreted from the intestines, so it is considered that the loss of gastrointestinal proteins in normal people under physiological conditions can be ignored. The pathogenesis of protein-losing gastrointestinal disease mainly includes the following aspects:

　　1. Gastrointestinal mucosal erosion or ulceration leading to protein leakage or exudation.

　　2. Mucosal cell injury or loss, widened intercellular tight junctions, leading to increased mucosal permeability and leakage of plasma proteins into the intestinal lumen.

　　3. Intestinal lymphatic obstruction, increased interstitial pressure. This causes the rich protein interstitial to not only not remain in the interstitium or be absorbed into the blood circulation, but rather to leak out and enter the intestinal lumen and be lost. The mechanism of protein loss in gastrointestinal disease caused by intestinal inflammation is not yet clear, and it may be due to the exudation of extracellular fluid and inflammatory fluid in the inflammatory area. Normally, the amount of plasma protein leaked into the gastrointestinal tract is not much, and it is estimated that these proteins are less than 6% of the blood albumin, only equivalent to 10% to 20% of the daily protein decomposition rate of these plasma proteins, of which more than 90% are digested and reabsorbed. Therefore, the catabolism of the gastrointestinal tract does not occupy an important position in the total catabolism of plasma proteins. In protein-losing gastrointestinal disease, the loss of plasma proteins from the gastrointestinal tract is far beyond the normal loss. The daily protein degradation rate in the gastrointestinal tract can reach 40% to 60% or more of the total circulating plasma protein. The loss of protein from the gastrointestinal tract in protein-losing gastrointestinal disease is unrelated to the molecular weight of the protein. A large amount of plasma protein leaks into the gastrointestinal tract, leading to a shortening of the half-life of plasma proteins and an acceleration of turnover rate. Studies have shown that in this disease, due to the leakage of plasma proteins from the gastrointestinal mucosa regardless of their molecular size, the slower the synthesis rate and/or the longer the half-life of plasma proteins, the more obvious the decrease. Albumin and IgG have a longer half-life. Even if the body performs compensatory synthesis, its ability is limited; the rate of albumin synthesis by the liver can be increased at most by a factor of 1; while the synthesis of IgG and other immunoglobulins is not stimulated by the decrease in plasma concentration, so the plasma concentration of albumin and IgG decreases the most in this disease, causing patients with this disease to often suffer from hypoalbuminemia. The proteins lost into the gastrointestinal cavity are decomposed into amino acids and peptides in the intestinal lumen and reabsorbed into the blood circulation as a source of nitrogen for the body. If a large amount of protein is lost into the gastrointestinal tract, enters the intestines quickly, or the intestinal peristalsis is fast, then a large amount of protein is excreted from the intestines. Those who lose protein from the intestines due to lymphatic obstruction may also lose lymphocytes from the intestines, resulting in a decrease in blood lymphocytes. In addition, other plasma components such as copper, calcium, iron, lipids, etc., can also be lost from the gastrointestinal tract.

　　Due to the decrease in plasma proteins, especially albumin, which leads to a decrease in colloid osmotic pressure of plasma, water moves from the blood vessels to interstitial spaces, as well as an increase in secondary aldosterone secretion, leading to water and sodium retention, systemic edema is most common with lower limb edema. Facial, upper limb, or umbilical edema may also occur, but systemic edema is rare..

　　Gastrointestinal cancer syndrome refers to a group of symptoms associated with some cancers of the digestive system, the clinical manifestations include the following aspects:

　　1. Protein-losing enteropathy

　　It is more common in gastric cancer and colon cancer, caused by the necrosis and shedding of cancer tissue, leading to increased permeability of the corresponding gastrointestinal mucosa, large amounts of plasma protein leaking and losing from the gastrointestinal tract, cancer tumor compression and obstruction of lymphatics, causing intestinal lymphatic回流受阻、lymphatic stasis、rupture, causing a large amount of protein loss, clinically manifested mainly by hypoproteinemia and edema.

　　2. Jejunal villous atrophy

　　It can be seen in colorectal cancer and rectal cancer, mainly manifested as diarrhea.

　　3. Diarrhea, dehydration, and shock

　　Mainly seen in colonic villous adenoma, occasionally seen in gastrointestinal APUD system tumors. Such as VIP tumor, gastrinoma, and pancreatic polypeptide tumor, etc., manifested as secretory diarrhea. It can lead to dehydration, electrolyte imbalance, and even shock.

      Protein-losing enteropathy is one of the gastrointestinal cancer syndromes. Effective treatment of the etiopathology of protein-losing enteropathy is the key to prevention. Determining the etiology of protein-losing enteropathy and adopting appropriate surgical, drug, and/or dietary interventions can partially or completely alleviate the hypoproteinemia, edema, and other clinical symptoms of these patients. The prognosis is poor for those caused by malignant tumors. Delayed diagnosis and treatment in children can lead to growth and development disorders, even death. Some adult patients may die of severe malnutrition and secondary infection due to delayed diagnosis and treatment.

      Gastrointestinal cancer syndrome refers to a group of symptoms associated with some cancers of the digestive system, which. The main clinical examinations include X-ray examination, jejunal mucosal biopsy, lymphangiography, and ascites examination.

　　1. X-ray examination

　　Gastrointestinal X-ray examination is of great significance for differential diagnosis. In particular, the following X-ray signs: giant thickening of the gastrointestinal mucosal folds (seen in hypertrophic secretory gastritis); X-ray signs of malabsorption (intestinal lumen dilation, snowy or feather-like barium sedimentation, barium distribution in segmented form, seen in various gastrointestinal diseases with malabsorption of protein loss); general thickening of the jejunal mucosal folds (lymphoma, Crohn's disease, primary intestinal lymphangiectasis, or secondary intestinal lymphatic obstruction); nodular change of the jejunal mucosa after finger pressure (lymphoma, Crohn's disease), abdominal CT scan helps to detect mesenteric lymph node enlargement, etc.

　　2. Jejunal mucosal biopsy

　　Multiple jejunal mucosal biopsies are significant for the diagnosis of lymphoma, celiac disease, eosinophilic gastroenteritis, collagenous gastroenteritis, intestinal lymphangiectasis, and Whipple's disease, etc.

　　3. Lymphangiography

　　Lymphangiography of the lower extremities is of great help in distinguishing between congenital and secondary intestinal lymphangiectasis. The former shows maldevelopment of peripheral lymphatics and thoracic duct lesions, with contrast medium retention in retroperitoneal lymph nodes, but the mesenteric lymphatic system is not filled; the latter shows contrast medium refluxing into the dilated mesenteric lymphatics and overflowing into the intestinal lumen or peritoneal cavity.

　　4. Ascites examination

　　Patients with ascites can undergo diagnostic puncture to examine the ascites cells, proteins, chyle micelles, enzymes, and malignant cells, etc.

　　Gastrointestinal cancer syndrome refers to a group of symptoms associated with certain cancers in the digestive system, so patients with gastrointestinal cancer syndrome should pay attention to the following aspects in their diet:

     1. Pay attention to soft, soft, and easy-to-digest food

     The staple foods, vegetables, and meat dishes such as fish and meat should be cooked thoroughly and well-done to make them soft and easy to digest. Eat less rough and fibrous foods, and the food should be well-prepared and nutritious.

　　2. Avoid irregular diet

      The dietary principles for gastritis should be light and non-irritating to the gastric mucosa, but not all light diets can alleviate the patient's symptoms. The principle should be regular diet, not too hungry or too full, and to eat less and more frequently. It is especially good for the elderly and weak, and those with decreased gastrointestinal function, with 4-5 meals a day, each meal being about 60-70% full. Pay attention to the proportion of sugar, fat, and protein in food, and the content of vitamins and other essential nutrients for the body.

　　Gastrointestinal cancer syndrome refers to a group of symptoms associated with certain cancers in the digestive system.. The treatment of gastrointestinal cancer syndrome mainly involves the resection of the primary tumor, and somatostatin analogs such as octreotide can also be used for treatment, which is effective in controlling diarrhea.

　　Laparoscopic treatment, similar to electronic gastroscopy. Laparoscopic surgery is a surgical procedure using laparoscopic instruments and related equipment. Cold light sources are used for illumination, and the laparoscopic lens (diameter of 3-10mm) is inserted into the abdominal cavity. Digital imaging technology is used to transmit the images captured by the laparoscopic lens through optical fibers to the downstream signal processing system, and they are displayed in real-time on a dedicated monitor. Then, the doctor analyzes and judges the patient's condition by observing the images of the patient's organs from different angles displayed on the monitor screen, and performs surgery using special laparoscopic instruments.