食管癌英文課件整理

食管癌英文食管癌英文1ContentAnatomyoftheEsophagusSummaryPathogeny(發(fā)病機(jī)制)ClinicalfeatureDiagnoseDifferentialdiagnosisExerciseContentAnatomyoftheEsophagu2AnatomyoftheEsophagusTheesophagusisamusculartube,whichisadigestiveorganbetweenthethroatandstomach.AnatomyoftheEsophagusThees3DifferentialdiagnosisT1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma.Haveahistoryoflivercirrhosis,portalhypertension.Smoothcircularcavityfillingdefectwithoutmucosalfoldbreakandsurroundingtissueinvasionandmetastasis.Esophagealvarices(食管靜脈曲張)Trachealbifurcation(氣管分叉)Tellmewhichesophagusdiseaseitisinthefollowingpictures.Whenthetumor

invade

thetrachea,tracheoesophagealfistula(氣管食管瘺)Onawideneduppersegment

withfluidlevelprotrudetype(隆起型)Constrictivetype(縮窄型)Limitingfillingdefect(局限性充盈缺損)Thesurroundingofthetumorbecomebulged,andthefoldsofmucousbecomedamaged.Theesophagusisamusculartube,whichisadigestiveorganbetweenthethroatandstomach.PhysiologicalstenosisofesophagusFirst:Thejunctionofthepharynx(咽)andesophagus.Second:locatedinthebackofleftprincipalbronchus.Third:Esophagealhiatus(食管裂孔).

DifferentialdiagnosisPhysiolo43SectionsoftheesophagusTheuppersegmentThemiddlesegment

（Carcinomaoccurmostfrequent）

ThelowersegmentTrachealbifurcation(氣管分叉)3SectionsoftheesophagusTh5SummaryCarcinomaoftheesophagusisacommonmalignanttumorthatoccursinapopulationcover40yearsold,andinpredilectionformale(好發(fā)于男性).SummaryCarcinomaoftheesopha6PrevalenceandmortalityTherearemorethan300,000peopleworldwidediedfromesophagealcancereachyear,and150,000ofthemareChinese.PrevalenceandmortalityThere7Pathogeny1.

Nitrosamine(亞硝胺)2.Fungus(真菌)3.Vitamindeficiency4.DietaryhabitsPathogeny1.Nitrosamine(亞硝胺)8

NitrosamineNitrosamines

contentofthese

foods

areveryhighNitrosamineNitrosamines

conte9Clinicalfeature

InearlystageSymptomsareoftennotobvious,butwhenswallowingthecoarsefood,differentdegreesofuncomfortablefeelingsmayoccur.ClinicalfeatureInearlystag10ClinicalfeatureInthemiddleandadvancedstageProgressive

dysphagia

(進(jìn)行性吞咽困難)Whenthetumor

invade

thetrachea,tracheoesophagealfistula(氣管食管瘺)Cachexia(惡病質(zhì))ClinicalfeatureInthemiddle11Classificationofesophageal

cancer1.Ulcerativetype(潰瘍型)2.Mushroomtype(蕈傘型)3.Constrictivetype(縮窄型)4.Medullarytype(髓質(zhì)型)Classificationofesophageal

c12Diagnose1.X-ray

barium

meal2.ComputedTomography(CT)3.MagneticResonanceImaging(MR)Diagnose1.X-ray

barium

meal131.X-ray

barium

meal(1).EarlystageEsophageal

mucosalfoldsbebeak(粘膜迂曲、斷裂)Singleor

multiplesmall

niches(龕影)Limitingfillingdefect(局限性充盈缺損)Bariumstream

slowor

temporary

residence(鋇劑流動緩慢或一過性滯留)1.X-ray

barium

meal(1).Early14PostoperationRecurPostoperation15Small

nodules(小結(jié)節(jié))Small

nodules(小結(jié)節(jié))16nicheProgressive

dysphagia

(進(jìn)行性吞咽困難)Thesurroundingofthetumorbecomebulged,andthefoldsofmucousbecomedamaged.DietaryhabitsThemiddlesegmentDifferentialdiagnosisLoweresophagusbecomethinlikeabeak(鳥嘴征)Vitamindeficiency（Carcinomaoccurmostfrequent）Second:locatedinthebackofleftprincipalbronchus.T2WI：Thefatlayerdisappearedandthewalloftracheabedamaged.InearlystageWhenthetumor

invade

thetrachea,tracheoesophagealfistula(氣管食管瘺)T1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma.protrudetype(隆起型)nicheprotrudetype(隆起型)17Early

ulcerativetypeEarly

ulcerativetype18Trachealbifurcation(氣管分叉)ClinicalfeaturePhysiologicalstenosisofesophagusInthemiddleandadvancedstageParaesophageal

fatlayer

fuzzy,

disappear.DietaryhabitsLimitingfillingdefect(局限性充盈缺損)Thecarcinomacanencroachonthewhole-layerofesophagusandmakeastenosis,withulcerationonit.Thecarcinomacanencroachonthewhole-layerofesophagusandmakeastenosis,withulcerationonit.EnhancedscanningT2WI：Thefatlayerdisappearedandthewalloftracheabedamaged.Tellmewhichesophagusdiseaseitisinthefollowingpictures.ClinicalfeatureHaveahistoryoflivercirrhosis,portalhypertension.EarlyconstrictivetypeTrachealbifurcation(氣管分叉)Ea19(2).Middleandadvancedstagea.Ulcerativetype(潰瘍型)

niche

Thesurroundingofthetumorbecomebulged,andthefoldsofmucousbecomedamaged.(周圍隆起,粘膜皺襞破壞)(2).Middleandadvancedstage20FillingdefectAnexpandoverthetumorb.MushroomtypeFillingdefectb.Mushroomtyp21c.ConstrictivetypeM,63Y,Progressive

dysphagia

20dc.ConstrictivetypeM,63Y,Pr22d.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-layerofesophagus

andmakeastenosis,withulcerationonit.d.Medullarytype廣泛侵犯食管全層,形成腔外232.CT1.Esophageal

wallcircularorirregularthickening(>5mm).2.Cavitylumpoccurred.3.Paraesophageal

fatlayer

fuzzy,

disappear.4.Peripheral

organgotinvolved

or

lymphnodemetastasis.5.Enhancedscanningshowed

mildenhancementof

tumor.2.CT1.Esophageal

wallcircul24食管癌英文課件整理25EnhancedscanningEnhancedscanning263.MRThereisasynechia(黏連)betweenthecancerandtheaorticarch.Thehighsignalfatlayerexist.3.MRThereisasynechia(黏連)b27CancerinvadethetracheaT2WI：Thefatlayerdisappearedandthewalloftracheabedamaged.T1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma.CancerinvadethetracheaT2WI：28Differentialdiagnosis1.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).Differentialdiagnosis1.Achal291.Achalasiaofcardiaandesophagus

Intermittent

dysphagia(間歇性吞咽困難)Onawideneduppersegment

withfluidlevelLoweresophagusbecomethinlikeabeak(鳥嘴征)Withoutmucosalfoldbreak.1.Achalasiaofcardiaandeso30食管癌英文課件整理312.EsophagealvaricesHaveahistoryoflivercirrhosis,portalhypertension.Beaded

fillingdefect(串珠樣充盈缺損)EnhancedCTscan

showed

vasculartortuosity

groupremarkableenhancementanddelayed

enhancement.Bariumemptyingdelay,butnoobstructionphenomenon.2.EsophagealvaricesHaveahi32食管癌英文課件整理33Thereisasynechia(黏連)betweenthecancerandtheaorticarch.Theesophagusisamusculartube,whichisadigestiveorganbetweenthethroatandstomach.DifferentialdiagnosisProgressive

dysphagia

(進(jìn)行性吞咽困難)T1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma.Whenthetumor

invade

thetrachea,tracheoesophagealfistula(氣管食管瘺)Intermittent

dysphagia(間歇性吞咽困難)Clinicalfeature廣泛侵犯食管全層,形成腔