食管癌(英文版)-课件

CarcinomaofEsophagusSpeaker:LiuRan1PPT课件CarcinomaofEsophagusContentAnatomyoftheEsophagusSummaryPathogeny(发病机制)ClinicalfeatureDiagnoseDifferentialdiagnosisExercise2PPT课件ContentAnatomyoftheEsophaguAnatomyoftheEsophagusTheesophagusisamusculartube,whichisadigestiveorganbetweenthethroatandstomach.3PPT课件AnatomyoftheEsophagusTheesPhysiologicalstenosisofesophagusFirst:Thejunctionofthepharynx(咽)andesophagus.Second:locatedinthebackofleftprincipalbronchus.Third:Esophagealhiatus(食管裂孔).

4PPT课件Physiologicalstenosisofesop3SectionsoftheesophagusTheuppersegmentThemiddlesegment

（Carcinomaoccurmostfrequent）

ThelowersegmentTrachealbifurcation(气管分叉)5PPT课件3SectionsoftheesophagusThSummaryCarcinomaoftheesophagusisacommonmalignanttumorthatoccursinapopulationcover40yearsold,andinpredilectionformale(好发于男性).6PPT课件SummaryCarcinomaoftheesophaPrevalenceandmortalityTherearemorethan300,000peopleworldwidediedfromesophagealcancereachyear,and150,000ofthemareChinese.7PPT课件PrevalenceandmortalityTherePathogeny1.

Nitrosamine(亚硝胺)2.Fungus(真菌)3.Vitamindeficiency4.Dietaryhabits8PPT课件Pathogeny1.Nitrosamine(亚硝胺)8P

NitrosamineNitrosamines

contentofthese

foods

areveryhigh9PPT课件NitrosamineNitrosamines

conteClinicalfeature

InearlystageSymptomsareoftennotobvious,butwhenswallowingthecoarsefood,differentdegreesofuncomfortablefeelingsmayoccur.10PPT课件ClinicalfeatureInearlystagClinicalfeatureInthemiddleandadvancedstageProgressive

dysphagia

(进行性吞咽困难)Whenthetumor

invade

thetrachea,tracheoesophagealfistula(气管食管瘘)Cachexia(恶病质)11PPT课件ClinicalfeatureInthemiddleClassificationofesophageal

cancer1.Ulcerativetype(溃疡型)2.Mushroomtype(蕈伞型)3.Constrictivetype(缩窄型)4.Medullarytype(髓质型)12PPT课件Classificationofesophageal

cDiagnose1.X-ray

barium

meal2.ComputedTomography(CT)3.MagneticResonanceImaging(MR)13PPT课件Diagnose1.X-ray

barium

meal131.X-ray

barium

meal(1).EarlystageEsophageal

mucosalfoldsbebeak(粘膜迂曲、断裂)Singleor

multiplesmall

niches(龛影)Limitingfillingdefect(局限性充盈缺损)Bariumstream

slowor

temporary

residence(钡剂流动缓慢或一过性滞留)14PPT课件1.X-ray

barium

meal(1).EarlyPostoperationRecur15PPT课件Postoperation15PPT课件Small

nodules(小结节)16PPT课件Small

nodules(小结节)16PPT课件protrudetype(隆起型)17PPT课件protrudetype(隆起型)17PPT课件Early

ulcerativetype18PPT课件Early

ulcerativetype18PPT课件Earlyconstrictivetype19PPT课件Earlyconstrictivetype19PPT课(2).Middleandadvancedstagea.Ulcerativetype(溃疡型)

niche

Thesurroundingofthetumorbecomebulged,andthefoldsofmucousbecomedamaged.(周围隆起,粘膜皱襞破坏)20PPT课件(2).MiddleandadvancedstageFillingdefectAnexpandoverthetumorb.Mushroomtype21PPT课件Fillingdefectb.Mushroomtypc.ConstrictivetypeM,63Y,Progressive

dysphagia

20d22PPT课件c.ConstrictivetypeM,63Y,Prd.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-layerofesophagus

andmakeastenosis,withulcerationonit.23PPT课件d.Medullarytype广泛侵犯食管全层,形成腔外2.CT1.Esophageal

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

fatlayer

fuzzy,

disappear.4.Peripheral

organgotinvolved

or

lymphnodemetastasis.5.Enhancedscanningshowed

mildenhancementof

tumor.24PPT课件2.CT1.Esophageal

wallcircul25PPT课件25PPT课件Enhancedscanning26PPT课件Enhancedscanning26PPT课件3.MRThereisasynechia(黏连)betweenthecancerandtheaorticarch.Thehighsignalfatlayerexist.27PPT课件3.MRThereisasynechia(黏连)bCancerinvadethetracheaT2WI：Thefatlayerdisappearedandthewalloftracheabedamaged.T1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma.28PPT课件CancerinvadethetracheaT2WI：Differentialdiagnosis1.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).29PPT课件Differentialdiagnosis1.Achal1.Achalasiaofcardiaandesophagus

Intermittent

dysphagia(间歇性吞咽困难)Onawideneduppersegment

withfluidlevelLoweresophagusbecomethinlikeabeak(鸟嘴征)Withoutmucosalfoldbreak.30PPT课件1.Achalasiaofcardiaandeso31PPT课件31PPT课件2.EsophagealvaricesHaveahistoryoflivercirrhosis,portalhypertension.Beaded

fillingdefect(串珠样充盈缺损)EnhancedCTscan

showed

vasculartortuosity

groupremarkableenhancementanddelayed

enhancement.Bariumemptyingdelay,butnoobstructionphenomenon.32PPT课件2.EsophagealvaricesHaveahi33PPT课件33PPT课件3.Leiomyomaoftheesophagus(食管平滑肌瘤)Smoothcircularcavityfillingdefectwithoutmucosalfoldbreakandsurroundingtissueinvasionandmetastasis.34PPT课件3.Leiomyomaoftheesophagus(35PPT课件35PPT课件Exercise1.Canurememberthe3physiologicalstenosisofesophagus?(InthisquestionucanansweritinChinese)2.Pleaseshowusthefourtypesofthecarcinomaofesophagus.3.Tellmewhichesophagusdiseaseitisinthefollowingpictures.36PPT课件Exercise1.CanuremembertheUlcerativecarcinoma37PPT课件Ulcerativecarcinoma37PPT课件TheendThankyou!38PPT课件TheendThankyou!38PPT课件CarcinomaofEsophagusSpeaker:LiuRan39PPT课件CarcinomaofEsophagusContentAnatomyoftheEsophagusSummaryPathogeny(发病机制)ClinicalfeatureDiagnoseDifferentialdiagnosisExercise40PPT课件ContentAnatomyoftheEsophaguAnatomyoftheEsophagusTheesophagusisamusculartube,whichisadigestiveorganbetweenthethroatandstomach.41PPT课件AnatomyoftheEsophagusTheesPhysiologicalstenosisofesophagusFirst:Thejunctionofthepharynx(咽)andesophagus.Second:locatedinthebackofleftprincipalbronchus.Third:Esophagealhiatus(食管裂孔).

42PPT课件Physiologicalstenosisofesop3SectionsoftheesophagusTheuppersegmentThemiddlesegment

（Carcinomaoccurmostfrequent）

ThelowersegmentTrachealbifurcation(气管分叉)43PPT课件3SectionsoftheesophagusThSummaryCarcinomaoftheesophagusisacommonmalignanttumorthatoccursinapopulationcover40yearsold,andinpredilectionformale(好发于男性).44PPT课件SummaryCarcinomaoftheesophaPrevalenceandmortalityTherearemorethan300,000peopleworldwidediedfromesophagealcancereachyear,and150,000ofthemareChinese.45PPT课件PrevalenceandmortalityTherePathogeny1.

Nitrosamine(亚硝胺)2.Fungus(真菌)3.Vitamindeficiency4.Dietaryhabits46PPT课件Pathogeny1.Nitrosamine(亚硝胺)8P

NitrosamineNitrosamines

contentofthese

foods

areveryhigh47PPT课件NitrosamineNitrosamines

conteClinicalfeature

InearlystageSymptomsareoftennotobvious,butwhenswallowingthecoarsefood,differentdegreesofuncomfortablefeelingsmayoccur.48PPT课件ClinicalfeatureInearlystagClinicalfeatureInthemiddleandadvancedstageProgressive

dysphagia

(进行性吞咽困难)Whenthetumor

invade

thetrachea,tracheoesophagealfistula(气管食管瘘)Cachexia(恶病质)49PPT课件ClinicalfeatureInthemiddleClassificationofesophageal

cancer1.Ulcerativetype(溃疡型)2.Mushroomtype(蕈伞型)3.Constrictivetype(缩窄型)4.Medullarytype(髓质型)50PPT课件Classificationofesophageal

cDiagnose1.X-ray

barium

meal2.ComputedTomography(CT)3.MagneticResonanceImaging(MR)51PPT课件Diagnose1.X-ray

barium

meal131.X-ray

barium

meal(1).EarlystageEsophageal

mucosalfoldsbebeak(粘膜迂曲、断裂)Singleor

multiplesmall

niches(龛影)Limitingfillingdefect(局限性充盈缺损)Bariumstream

slowor

temporary

residence(钡剂流动缓慢或一过性滞留)52PPT课件1.X-ray

barium

meal(1).EarlyPostoperationRecur53PPT课件Postoperation15PPT课件Small

nodules(小结节)54PPT课件Small

nodules(小结节)16PPT课件protrudetype(隆起型)55PPT课件protrudetype(隆起型)17PPT课件Early

ulcerativetype56PPT课件Early

ulcerativetype18PPT课件Earlyconstrictivetype57PPT课件Earlyconstrictivetype19PPT课(2).Middleandadvancedstagea.Ulcerativetype(溃疡型)

niche

Thesurroundingofthetumorbecomebulged,andthefoldsofmucousbecomedamaged.(周围隆起,粘膜皱襞破坏)58PPT课件(2).MiddleandadvancedstageFillingdefectAnexpandoverthetumorb.Mushroomtype59PPT课件Fillingdefectb.Mushroomtypc.ConstrictivetypeM,63Y,Progressive

dysphagia

20d60PPT课件c.ConstrictivetypeM,63Y,Prd.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-layerofesophagus

andmakeastenosis,withulcerationonit.61PPT课件d.Medullarytype广泛侵犯食管全层,形成腔外2.CT1.Esophageal

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

fatlayer

fuzzy,

disappear.4.Peripheral

organgotinvolved

or

lymphnodemetastasis.5.Enhancedscanningshowed

mildenhancementof

tumor.62PPT课件2.CT1.Esophageal

wallcircul63PPT课件25PPT课件Enhancedscanning64PPT课件Enhancedscanning26PPT课件3.MRThereisasynechia(黏连)betweenthecancerandtheaorticarch.Thehighsignalfatlayerexist.65PPT课件3.MRThereisasynechia(黏连)bCancerinvadethetracheaT2WI：Thefatlayerdisappearedandthewalloftracheabedamaged.T1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma.66PPT课件CancerinvadethetracheaT2WI：Differentialdiagnosis1.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).67PPT课件Differentialdiagnosis1.Achal1.Achalasiaofcardiaand