浅表下咽癌内镜诊治.pptVIP

浅表下咽癌内镜诊治 王磊2019-07-29  咽部解剖 四 pharynx 咽的位置 咽部 pharynx在鼻nose, 口 mouth,喉 larynx 后方,上达颅底,下至 第6颈椎下缘(环状软骨 coid cartilage下缘) 下接食道 esophagus 呼吸和消化的共同通道 长约12cm  下咽部范围 梨状窝 环后区  ·下咽位于头颈部重要的解剖部位,与吞咽 和发音关系密切。下咽瘟虽然发病率不高 约占整个头颈部肿瘤的6.5%,但却是头颈 部肿瘤中预后最差的,其5年总生存率约为 30%*,所以早期发现尤其重要。 *Trends inincider the United States: a site specific analysis of the SEER base[]. Int J Cancer, 2005, 114(5): 806-816 *Kuo p chen MM RH, et al. Hypopharyngeal cancer incidence, treatment, and survival: temporal trends in the Unite ope,2014124{9):2064-2069  表在癌⑦壁深達度 上皮下層浸潤癌 上皮内癌 上皮 上皮下層 固有筋唇 无论淋巴结有无转移 疏頭部癌取0圾认规豹第5版(2012年6月)女0引用 Su-perficial cancerswere defined as the cancers that infiltrated up to the subepithelial layer(SEP)without muscular layer(MP)invasion, as proposed in the previous literature Oda I Y Feasibility of endoscopic mucosal resection for superficial treatment. endosco  咽部粘膜因为没有粘膜肌层,所以沿用“上皮下层″这个概念 下咽部早癌不能像食道早癌那样有组织学性地识别各层深度,并 按浸润深度评估其不同淋巴节转移的风险。 esophagus hypopharynx EPLPM: mucosa SM SM=subepithelial layer MP MP  下咽癌与食管癌的关系  Effect of routine esophageal screening in patients with head and neck cancer. sYr, Chen wC, Chiann Hc, GuD cs, Ln YT Author information I Departments of otolaryngology, Kaohsiung Chang Gung Memorial Hospltal, Kaohsiung, Talwan. IMPORTANCE. asal esophagoscopy or pandoscopy to conduct a Despite this recommendation, the effert of routine esophageal screening OBJECTIVE: Te es econd el carcinoma e among patients with HNSCC. laivaspective study at the Academic Institute of Otolaryngology, Kachsiung, INTERVENTION: Patients were divided int based on whether or not they had recelved ng, and the 2 groups rere compared. The prevalence and cancer stage of second primary ESCC arnong these 2 groups were compared using ESCC R8.89 he routine screening group were diagnosed at a earlier cancer stage than patients in the non-routi ing group ONCLUSIONS AND RELEVANCE: Routine esophageal screening is recommended for pa