食管癌課件(英文版).pptx

CarcinomaofEsophagus Speaker LiuRan Content AnatomyoftheEsophagusSummaryPathogeny 發(fā)病機(jī)制 ClinicalfeatureDiagnoseDifferentialdiagnosisExercise AnatomyoftheEsophagus Theesophagusisamusculartube whichisadigestiveorganbetweenthethroatandstomach Physiologicalstenosisofesophagus First Thejunctionofthepharynx 咽 andesophagus Second locatedinthebackofleftprincipalbronchus Third Esophagealhiatus 食管裂孔 3Sectionsoftheesophagus TheuppersegmentThemiddlesegment Carcinomaoccurmostfrequent Thelowersegment Trachealbifurcation 氣管分叉 Summary Carcinomaoftheesophagusisacommonmalignanttumorthatoccursinapopulationcover40yearsold andinpredilectionformale 好發(fā)于男性 Prevalenceandmortality Therearemorethan300 000peopleworldwidediedfromesophagealcancereachyear and150 000ofthemareChinese Pathogeny 1 Nitrosamine 亞硝胺 2 Fungus 真菌 3 Vitamindeficiency4 Dietaryhabits Nitrosamine Nitrosaminescontentofthesefoodsareveryhigh Clinicalfeature InearlystageSymptomsareoftennotobvious butwhenswallowingthecoarsefood differentdegreesofuncomfortablefeelingsmayoccur Clinicalfeature InthemiddleandadvancedstageProgressivedysphagia 進(jìn)行性吞咽困難 Whenthetumorinvadethetrachea tracheoesophagealfistula 氣管食管瘺 Cachexia 惡病質(zhì) Classificationofesophagealcancer 1 Ulcerativetype 潰瘍型 2 Mushroomtype 蕈傘型 3 Constrictivetype 縮窄型 4 Medullarytype 髓質(zhì)型 Diagnose 1 X raybariummeal2 ComputedTomography CT 3 MagneticResonanceImaging MR 1 X raybariummeal 1 EarlystageEsophagealmucosalfoldsbebeak 粘膜迂曲 斷裂 Singleormultiplesmallniches 龕影 Limitingfillingdefect 局限性充盈缺損 Bariumstreamslowortemporaryresidence 鋇劑流動緩慢或一過性滯留 PostoperationRecur Smallnodules 小結(jié)節(jié) protrudetype 隆起型 Earlyulcerativetype Earlyconstrictivetype 2 Middleandadvancedstage a Ulcerativetype 潰瘍型 niche Thesurroundingofthetumorbecomebulged andthefoldsofmucousbecomedamaged 周圍隆起 粘膜皺襞破壞 FillingdefectAnexpandoverthetumor b Mushroomtype c Constrictivetype M 63Y Progressivedysphagia20d d Medullarytype 廣泛侵犯食管全層 形成腔外腫物 管腔狹窄 表面可見潰瘍 Thecarcinomacanencroachonthewhole layerofesophagusandmakeastenosis withulcerationonit 2 CT 1 Esophagealwallcircularorirregularthickening 5mm 2 Cavitylumpoccurred 3 Paraesophagealfatlayerfuzzy disappear 4 Peripheralorgangotinvolvedorlymphnodemetastasis 5 Enhancedscanningshowedmildenhancementoftumor Enhancedscanning 3 MR Thereisasynechia 黏連 betweenthecancerandtheaorticarch Thehighsignalfatlayerexist Cancerinvadethetrachea T2WI Thefatlayerdisappearedandthewalloftracheabedamaged T1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma Differentialdiagnosis 1 Achalasiaofcardiaandesophagus 食管賁門失弛緩征 2 Esophagealvarices 食管靜脈曲張 3 Leiomyomaoftheesophagus 食道平滑肌瘤 1 Achalasiaofcardiaandesophagus Intermittentdysphagia 間歇性吞咽困難 OnawideneduppersegmentwithfluidlevelLoweresophagusbecomethinlikeabeak 鳥嘴征 Withoutmucosalfoldbreak 2 Esophagealvarices Haveahistoryoflivercirrhosis portalhypertension Beadedfillingdefect 串珠樣充盈缺損 EnhancedCTscanshowedvasculartortuositygroupremarkableenhancementanddelayedenhancement Bariumemptyingdelay butnoobstructionphenomenon 3 Leiomyomaoftheesophagus 食管平滑肌瘤 Smoothcircularcavityfillingdefectwithoutmucosalfoldbreakandsurroundingtissueinvasionandmetastasis Exercise 1 Canurememberthe3physiologicalstenosisofesophagus Inthisquestio