外科精品教学课件（重庆医科大学）7，食管疾病Esophageal cancer（食管疾病）-朱冰.pptVIP

Esophageal cancer Epidemiology Esophageal cancer---a relatively rare China, Iceland, India and Japan, as well as the United Kingdom 15,000 new esophageal cancer --in the United States. 30,0000—in China mortality rates primarily squamous cell cancer and adenocarcinoma Squamous cell cancer arises from the cells that line the upper part of the esophagus Adenocarcinoma arises from glandular cells that are present at the junction of the esophagus and stamoch Endoscopic image of patient with esophageal adenocarcinoma seen at gastro-esophageal junction Signs and symptoms Early esophageal cancer usually does not cause symptoms Mid stage—progressive Dysphagia: bulky substances (such as bread or meat)-- Fluids and soft foods Late stage: Pain between the shoulder blades Hoarseness Vomiting Coughing up blood Bucking(呛咳) in swallowing vomiting up blood upper airway obstruction and superior vena cava syndrome If the disease has spread elsewhere, this may lead to symptoms related to this: Causes and risk factors Increased risk Age. Most patients are over 60 Sex. It is more common in men. Heredity Tobacco smoking and heavy alcohol use increase the risk Gastroesophageal reflux disease (GERD) and its resultant Barretts esophagus Human papillomavirus (HPV) Corrosive injury to esophagus by swallowing strong alkalines (lye) or acids. Particular dietary substances, such as nitrosamine. Obesity increases the risk of adenocarcinoma fourfold Drinking large quantities of hot beverages, especially hot brewed teas Decreased risk Risk appears to be less in patients using aspirin or related drugs green and yellow vegetables and fruits are associated with a decreased risk of esophageal cancer. Moderate coffee consumption is associated with a decreased risk. eating pizza more than once a week appears to be a favorable indicator of risk for digestive tract neoplasms in this population. Diagnosis barium swallow or barium meal endoscopy; Biopsies Computed tomograp