食管癌(英文版).ppt

CarcinomaofEsophagus Speaker LiuRan Content AnatomyoftheEsophagusSummaryPathogeny 发病机制 ClinicalfeatureDiagnoseDifferentialdiagnosisExercise AnatomyoftheEsophagus Theesophagusisamusculartube whichisadigestiveorganbetweenthethroatandstomach Physiologicalstenosisofesophagus First Thejunctionofthepharynx 咽 andesophagus Second locatedinthebackofleftprincipalbronchus Third Esophagealhiatus 食管裂孔 3Sectionsoftheesophagus TheuppersegmentThemiddlesegment Carcinomaoccurmostfrequent Thelowersegment Trachealbifurcation 气管分叉 Summary Carcinomaoftheesophagusisacommonmalignanttumorthatoccursinapopulationcover40yearsold andinpredilectionformale 好发于男性 Prevalenceandmortality Therearemorethan300 000peopleworldwidediedfromesophagealcancereachyear and150 000ofthemareChinese Pathogeny 1 Nitrosamine 亚硝胺 2 Fungus 真菌 3 Vitamindeficiency4 Dietaryhabits Nitrosamine Nitrosaminescontentofthesefoodsareveryhigh Clinicalfeature InearlystageSymptomsareoftennotobvious butwhenswallowingthecoarsefood differentdegreesofuncomfortablefeelingsmayoccur Clinicalfeature InthemiddleandadvancedstageProgressivedysphagia 进行性吞咽困难 Whenthetumorinvadethetrachea tracheoesophagealfistula 气管食管瘘 Cachexia 恶病质 Classificationofesophagealcancer 1 Ulcerativetype 溃疡型 2 Mushroomtype 蕈伞型 3 Constrictivetype 缩窄型 4 Medullarytype 髓质型 Diagnose 1 X raybariummeal2 ComputedTomography CT 3 MagneticResonanceImaging MR 1 X raybariummeal 1 EarlystageEsophagealmucosalfoldsbebeak 粘膜迂曲 断裂 Singleormultiplesmallniches 龛影 Limitingfillingdefect 局限性充盈缺损 Bariumstreamslowortemporaryresidence 钡剂流动缓慢或一过性滞留 PostoperationRecur Smallnodules 小结节 protrudetype 隆起型 Earlyulcerativetype Earlyconstrictivetype 2 Middleandadvancedstage a Ulcerativetype 溃疡型 niche Thesurroundingofthetumorbecomebulged andthefoldsofmucousbecomedamaged 周围隆起 粘膜皱襞破坏 FillingdefectAnexpandoverthetumor b Mushroomtype c Constrictivetype M 63Y Progressivedysphagia20d d Medullarytype 广泛侵犯食管全层 形成腔外肿物 管腔狭窄 表面可见溃疡 Thecarcinomacanencroachonthewhole layerofesophagusandmakeastenosis withulcerationonit 2 CT 1 Esophagealwallcircularorirregularthickening 5mm 2 Cavitylumpoccurred 3 Paraesophagealfatlayerfuzzy disappear 4 Peripheralorgangotinvolvedorlymphnodemetastasis 5 Enhancedscanningshowedmildenhancementoftumor Enhancedscanning 3 MR Thereisasynechia 黏连 betweenthecancerandtheaorticarch Thehighsignalfatlayerexist Cancerinvadethetrachea T2WI Thefatlayerdisappearedandthewalloftracheabedamaged T1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma Differentialdiagnosis 1 Achalasiaofcardiaandesophagus 食管贲门失弛缓征 2 Esophagealvarices 食管静脉曲张 3 Leiomyomaoftheesophagus 食道平滑肌瘤 1 Achalasiaofcardiaandesophagus Intermittentdysphagia 间歇性吞咽困难 OnawideneduppersegmentwithfluidlevelLoweresophagusbecomethinlikeabeak 鸟嘴征 Withoutmucosalfoldbreak 2 Esophagealvarices Haveahistoryoflivercirrhosis portalhypertension Beadedfillingdefect 串珠样充盈缺损 EnhancedCTscanshowedvasculartortuositygroupremarkableenhancementanddelayedenhancement Bariumemptyingdelay butnoobstructionphenomenon 3 Leiomyomaoftheesophagus 食管平滑肌瘤 Smoothcircularcavityfillingdefectwithoutmucosalfoldbreakandsurroundingtissueinvasionandmetastasis Exercise 1 Canurememberthe3physiologicalstenosisofesophagus Inthisquesti