esophageal cancer

Disease name

open 8 entries with the same name

Collection

zero Useful+1

zero

synonym Esophageal cancer (Esophageal cancer) generally refers to esophageal cancer (disease name)

This entry is made by Compilation and application of scientific encyclopedia entries of "Science Popularization China" authentication.

Zhou Aiping

(Chief Physician) Review

Department of Oncology, Cancer Hospital, Chinese Academy of Medical Sciences

Esophageal cancer is a common tumor of digestive tract, and about 300000 people die of it every year in the world. Its incidence and mortality There are great differences among countries. China is one of the high incidence areas of esophageal cancer in the world, with an average of 150000 deaths every year. Men are more than women, and the onset age is more than 40 years old. The typical symptom of esophageal cancer is progressive Dysphagia , first the food that is difficult to swallow, then Semiliquid food Finally, water and saliva cannot be swallowed. There are 6 high incidence areas of esophageal cancer in China, distributed in Shanxi and Guangdong Chaoshan area Hebei, Jiangsu, Sichuan, Henan.^[3]

TCM disease name: esophageal cancer
Foreign name: esophageal carcinoma
Alias: Esophageal cancer
Visiting department: Oncology Department

Multiple population: People over 40
Common causes: It may be caused by environment, eating habits and other factors
common symptom: Choking sensation of pharyngeal food, pain behind sternum, progressive dysphagia
infectivity: nothing

catalog

nine High risk group

pathogeny

Announce

edit

The population distribution and age, gender, occupation, race, region environment , eating habits Genetic susceptibility And so on. The existing investigation data show that esophageal cancer may be caused by a variety of factors. The proposed causes are as follows:

1. Chemical etiology

Nitrosamine 。 These compounds and their precursors are widely distributed and can be formed in vivo and in vitro, carcinogenicity Strong. In the diet, drinking water, sauerkraut, and even the saliva of patients in high incidence areas nitrite The content is far higher than that in low incidence areas.

2. Biological etiology

fungus. In some high incidence areas digestive tract A variety of fungi can be isolated from middle or resected esophageal cancer specimens, some of which are Carcinogenesis 。 Some fungi can promote the formation of nitrosamines and their precursors, and further promote the occurrence of cancer.

3. Lack of some trace element

Molybdenum, iron, zinc, fluorine and selenium are low in grains, vegetables and drinking water.

4. Lack of vitamins

Lack of vitamin A Vitamin B2 、 vitamin C as well as animal protein Inadequate intake of fresh vegetables and fruits is a common feature of high incidence areas of esophageal cancer.

5. Tobacco, wine, hot food hot drink , unclean mouth and other factors

Long term drinking Liquor . Have a penchant for smoking, and the food is too hard, too hot, or too fast, which causes chronic irritation, inflammation, trauma, or unclean mouth dental caries All these may be related to the occurrence of esophageal cancer.

6. Genetic predisposing factors of esophageal cancer.

distribution

Announce

edit

There are 6 high incidence areas of esophageal cancer in China, which are distributed in Shanxi, Guangdong (Chaoshan), Hebei, Jiangsu, Sichuan and Henan. Among them, the mortality rate of esophageal cancer in five high incidence areas in the north central part of the country has declined year by year, except Chaoshan, which is located in the southeast coast. Since the 1970s, the incidence and death trend of esophageal cancer has remained high, especially in Shantou Nan'ao Island (in the past, the island lacked fresh vegetables, and residents relied more on pickles).^[3] There is a special high incidence of malignant disease - esophageal cancer in Chaoshan area, which is related to people's eating habits such as drinking hot tea and eating pickled food.^[4]

clinical manifestation

Announce

edit

1. Early

Symptoms are often not obvious, but there may be different degrees of discomfort when swallowing coarse and hard food, including swallowing food Choking Sense, sternum Post burning sample acupuncture Pain like traction or friction. Food passes slowly, and there is a sense of stagnation or foreign body. The sense of stagnation due to choking often disappears after swallowing water. Symptoms vary from mild to severe, and progress is slow.

2. Middle and late stage

The typical symptom of esophageal cancer is progressive Dysphagia , first the food that is difficult to swallow, then Semiliquid food Finally, water and saliva cannot be swallowed. They often spit mucoid sputum, which is the saliva of the pharynx and the secretion of the esophagus. The patient gradually lost weight, dehydration and weakness. continued Chest pain or backache It is an advanced symptom, and the cancer has invaded the tissues outside the esophagus. When the inflammatory edema caused by cancer obstruction subsides temporarily, or after part of the cancer falls off, the obstruction symptoms can be temporarily alleviated, often mistaken for the improvement of the condition. If the cancer invades Recurrent laryngeal nerve , can appear hoarseness ； If the cervical sympathetic ganglion is compressed Horner syndrome ； If the gas pipe is invaded a bronchial tube , which can form esophageal, tracheal or bronchial fistula, and is severe when swallowing water or food Cough , and occurs respiratory system Infected. Last Cachexia Status. If there is metastasis of liver, brain and other organs jaundice 、 Ascites , coma, etc.

physical examination Special attention shall be paid to clavicle Whether there is increase on lymph gland Whether the liver has mass and ascites Pleural effusion Isodistant metastasis signs.

inspect

Announce

edit

For suspicious cases, Should be do esophagus Swallow dilute barium X-ray Double contrast radiography 。 Early visible: ① Esophagus Mucosal plica Disorder, roughness or interruption; ② Small Filling defect ；③ The localized pipe wall is stiff and the creep is interrupted; ④ Small Niche shadow 。 In the middle and late stage, there were obvious irregular stenosis and filling defect, and the tube wall was rigid. Sometimes, the upper oral side esophagus of stenosis has different degrees of expansion. B-ultrasonic inspection Whether there is metastasis of liver and other organs. laboratory examination anemia Degree and Carcinoembryonic antigen testing. CT examination Whether there is metastasis in brain, lung, etc.

differential diagnosis

Announce

edit

If there is no dysphagia in the early stage, contact Esophagitis 、 Diverticulum of esophagus and Esophageal varices Phase identification. If you have difficulty swallowing, you should contact Benign tumor of esophagus 、 Achalasia of cardia Differentiate from benign stricture of esophagus. The differential diagnosis mainly depends on barium swallow X-ray esophagography and Fiber esophagoscopy 。

treatment

Announce

edit

branch Surgery Treatment Radiotherapy 、 Chemotherapy and combined treatment 。

one surgical treatment

Surgery is the first choice for the treatment of esophageal cancer. If the general condition is good Cardiopulmonary function Surgical treatment can be considered for those with reserve and no obvious signs of distant metastasis. Generally, the cervical cancer is less than 3 cm long, the upper thoracic cancer is less than 4 cm long, and the lower thoracic cancer is less than 5 cm long. However, there are also Tumor body Not too big but has been connected with major organs, such as aorta , trachea, etc. are closely adhered and cannot be removed. For larger Squamous cell carcinoma If it is estimated that the possibility of resection is not high and the patient's general condition is good, it can be used first Preoperative radiotherapy The operation shall be performed after the tumor body shrinks.

Operation contraindications: ① The general condition is poor, and has been shown Cachexia 。 Or serious heart, lung or liver Renal insufficiency ② The lesion has a large scope of invasion, with obvious invasion and perforation sign , e.g. already present hoarseness Or existing Esophagotracheal fistula ③ Those with distant metastasis.

two Radiotherapy

① Combined radiotherapy and surgery can increase the surgical resection rate and improve the long-term survival rate 。 Preoperative radiotherapy After that, it is more appropriate to rest for 3 to 4 weeks before performing surgery. Metal markers shall be made at the residual cancer tissues that are incompletely resected during the operation, generally starting 3 to 6 weeks after the operation Postoperative radiotherapy 。② Simple radiotherapy is mostly used for cervical and upper thoracic esophageal cancer, and surgery for such patients is often difficult, complication More, the curative effect is unsatisfactory; It can also be used for patients with surgical contraindications and short lesion time, who can tolerate radiotherapy.

3. Chemotherapy

use chemotherapy Combined with surgery or radiotherapy and traditional Chinese medicine, the comprehensive treatment can sometimes improve the curative effect, or relieve the symptoms of patients with esophageal cancer and prolong the survival period. But to Regular inspection Hemogram And liver and kidney functions, and pay attention to Drug reaction 。

prevention

Announce

edit

In the late 1950s, China began to study the prevention and treatment of esophageal cancer, and established prevention and treatment research sites in rural areas of high incidence areas. Education and application of esophagus for people in high incidence areas cytology diagnostic method Carry out general survey to find early treatment , improve cure rate 。

How to keep away from esophageal cancer?

1. Develop a good lifestyle, eat less and eat more meals, chew slowly, do not eat too hot food, avoid eating moldy rice, noodles, peanuts and other foods and overnight meals, and reduce the intake of strong tea, coffee, liquor and other stimulating foods.

2. Have a reasonable diet, pay attention to the diversity of diet, and eat more fresh vegetables and fruits.

3. Reduce the intake of cured and smoked foods.

4. No smoking, no drinking, male or female.

5. Popularize cancer prevention knowledge and improve cancer prevention awareness for high-risk groups in high incidence areas (over 40 years old, from high incidence areas of esophageal cancer, family history of upper gastrointestinal cancer or upper gastrointestinal symptoms).

scientific research

Announce

edit

In October 2022, Chinese experts The new molecular pathway mechanism driving the malignant progression of esophageal cancer was clarified.^[1]

High risk group

Announce

edit

Generally speaking, the following people are easy to get esophageal cancer:

People who are accustomed to eating pickles and pickled food.

These foods contain nitrosamines, which are recognized as strong carcinogens worldwide.

Like to eat hot food and eat too fast, it is also easy to stimulate the esophageal mucosa, leading to cancer.

People who consume too much smoked food.

Fumigated fish, meat, sausage and other foods contain benzopyrene and other harmful substances, increasing the risk of esophageal cancer.

People who like to eat coarse food, lack trace elements such as molybdenum, zinc, magnesium, manganese, cobalt and iron, and are malnourished.

People who smoke and drink for a long time.^[2]

Novice on the road

Growth task Getting Started with Editing Edit Rule Edit by myself

I have questions

Content query Online Service Official post bar Feedback

Complaints and suggestions

Report bad information Failed to appeal through entries Complaint of infringement information Blocking query and unblocking

Jinggong Network Anbei No. 1100000200001