食管癌英文课件

食管癌英文ContentAnatomyoftheEsophagusSummaryPathogeny(发病机制)ClinicalfeatureDiagnoseDifferentialdiagnosisExerciseAnatomyoftheEsophagusTheesophagusisamusculartube,whichisadigestiveorganbetweenthethroatandstomach.PhysiologicalstenosisofesophagusFirst:Thejunctionofthepharynx(咽)andesophagus.Second:locatedinthebackofleftprincipalbronchus.Third:Esophagealhiatus(食管裂孔).

3SectionsoftheesophagusTheuppersegmentThemiddlesegment

（Carcinomaoccurmostfrequent）

ThelowersegmentTrachealbifurcation(气管分叉)SummaryCarcinomaoftheesophagusisacommonmalignanttumorthatoccursinapopulationcover40yearsold,andinpredilectionformale(好发于男性).PrevalenceandmortalityTherearemorethan300,000peopleworldwidediedfromesophagealcancereachyear,and150,000ofthemareChinese.Pathogeny1.

Nitrosamine(亚硝胺)2.Fungus(真菌)3.Vitamindeficiency4.Dietaryhabits

NitrosamineNitrosamines

contentofthese

foods

areveryhighClinicalfeature

InearlystageSymptomsareoftennotobvious,butwhenswallowingthecoarsefood,differentdegreesofuncomfortablefeelingsmayoccur.ClinicalfeatureInthemiddleandadvancedstageProgressive

dysphagia

(进行性吞咽困难)Whenthetumor

invade

thetrachea,tracheoesophagealfistula(气管食管瘘)Cachexia(恶病质)Pathogeny(发病机制)（Carcinomaoccurmostfrequent）3SectionsoftheesophagusFungus(真菌)EsophagealvaricesNitrosamine(亚硝胺)Onawideneduppersegment

withfluidlevelTrachealbifurcation(气管分叉)Enhancedscanningshowed

mildenhancementof

tumor.EnhancedCTscan

showed

vasculartortuosity

groupremarkableenhancementanddelayed

enhancement.Thesurroundingofthetumorbecomebulged,andthefoldsofmucousbecomedamaged.Classificationofesophageal

cancerLeiomyomaoftheesophagus

(食道平滑肌瘤).Cavitylumpoccurred.FillingdefectBariumstream

slowor

temporary

residence(钡剂流动缓慢或一过性滞留)Trachealbifurcation(气管分叉)Esophageal

mucosalfoldsbebeak(粘膜迂曲、断裂)Classificationofesophageal

cancer1.Ulcerativetype(溃疡型)2.Mushroomtype(蕈伞型)3.Constrictivetype(缩窄型)4.Medullarytype(髓质型)Diagnose1.X-ray

barium

meal2.ComputedTomography(CT)3.MagneticResonanceImaging(MR)1.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)PostoperationRecurSmall

nodules(小结节)protrudetype(隆起型)Early

ulcerativetypeEarlyconstrictivetype(2).Middleandadvancedstagea.Ulcerativetype(溃疡型)

niche

Thesurroundingofthetumorbecomebulged,andthefoldsofmucousbecomedamaged.(周围隆起,粘膜皱襞破坏)FillingdefectAnexpandoverthetumorb.Mushroomtypec.ConstrictivetypeM,63Y,Progressive

dysphagia

20dTherearemorethan300,000peopleworldwidediedfromesophagealcancereachyear,and150,000ofthemareChinese.Esophagealvarices(食管静脉曲张)Thereisasynechia(黏连)betweenthecancerandtheaorticarch.Mushroomtype(蕈伞型)Limitingfillingdefect(局限性充盈缺损)Trachealbifurcation(气管分叉)FillingdefectPleaseshowusthefourtypesofthecarcinomaofesophagus.Thehighsignalfatlayerexist.ThelowersegmentThesurroundingofthetumorbecomebulged,andthefoldsofmucousbecomedamaged.Whenthetumor

invade

thetrachea,tracheoesophagealfistula(气管食管瘘)Ulcerativetype(溃疡型)Enhancedscanningshowed

mildenhancementof

tumor.AnatomyoftheEsophagusComputedTomography(CT)Classificationofesophageal

cancerVitamindeficiencyNitrosamines

contentofthese

foods

areveryhighThehighsignalfatlayerexist.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-layerofesophagus

andmakeastenosis,withulcerationonit.2.CT1.Esophageal

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

fatlayer

fuzzy,

disappear.4.Peripheral

organgotinvolved

or

lymphnodemetastasis.5.Enhancedscanningshowed

mildenhancementof

tumor.Enhancedscanning3.MRThereisasynechia(黏连)betweenthecancerandtheaorticarch.Thehighsignalfatlayerexist.CancerinvadethetracheaT2WI：Thefatlayerdisappearedandthewalloftracheabedamaged.T1Wenhancescanningshowsalumpinthetracheaandbeenhancedlikethecarcinoma.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).1.Achalasiaofcardiaandesophagus

Intermittent

dysphagia(间歇性吞咽困难)Onawideneduppersegment

withfluidlevelLoweresophagusbecomethinlikeabeak(鸟嘴征)Withoutmucosalfoldbreak.2.EsophagealvaricesHaveahistoryoflivercirrhosis,portalhypertension.Beaded

fillingdefect(串珠样充盈缺损)EnhancedCTscan

showed

vasculartortuosity

groupremarkableenhancementanddelayed

enhancement.Bariumemptyingdelay,butnoobstructionphenomenon.3.Leiomyomaoftheesophagus(食管平滑肌瘤)Smoothcircularcavityfillingdefectwithoutmucosalfoldbreakandsurroundingtissueinvasionandmetastasis.Exercise1.Canurememberthe3physiologicalstenosisofesophagus?(InthisquestionucanansweritinChinese)2.Pleaseshowusthefourtypesofthecarcinomaofesophagus.3.Tellmewhichesophagusdiseaseitisinthefollowingpictures.Mushroomtype(蕈伞型)Thecarcinomacanencroachonthewhole-layerofesophagusandmakeastenosis,withulcerationonit.Nitrosamines

contentofthese

foods

areveryhighThelowersegmentEnhancedscanningshowed

mildenhancementof

tumor.AnatomyoftheEsophagusSecond:locatedinthebackofleftprincipalbronchus.PhysiologicalstenosisofesophagusSecond:locatedinthebackofleftprincipalbronchus.Canurememberthe3physiologicalstenosisofesophagus?(InthisquestionucanansweritinChinese)Progressive

dysphagia

(进行性吞咽困难)FillingdefectThemiddlesegmentPleaseshowusthefourtypesofthecarcinomaofesophagus.Clinicalfeature3SectionsoftheesophagusLeiomyomaoftheesophagus

(食道平滑肌瘤).Haveahistoryoflivercirrhosis,portalhypertension.PhysiologicalstenosisofesophagusThehighsignalfatlayerexist.UlcerativecarcinomaTheendThankyou!Enhancedscanningshowed

mildenhancementof

tumor.Cavitylumpoccurred.Thesurroundingofthetumorbecomebulged,andthefoldsofmucousbecomedamaged.DifferentialdiagnosisPeripheral

organgotinvolved

or

lymphnodemetastasis.Small

nodules(小结节)Third:Esophagealhiatus(食管裂孔).Esophageal

wallcircularorirregularthickening(>5mm).CancerinvadethetracheaClassificationofesophageal

cancerAnatomyoftheEsophagusThereisasynechia(黏连)betweenthecancerandtheaorticarch.Whenthetumor

invade

thetrachea,tracheoesophagealfistula(气管食管瘘)PrevalenceandmortalityFillingdefect广泛侵犯食管全层,形成腔外肿物，管腔狭窄，表面可见溃疡Thehighsignalfatlayerexist.MushroomtypePleaseshowusthefourtypesofthecarcinomaofesophagus.ClinicalfeaturePeripheral

organgotinvolved

or

lymphnodemetastasis.Trachealbifurcation(气管分叉)Whenthetumor

invade

thetrachea,tracheoesophagealfistula(气管食管瘘)Bariumstream

slowor

temporary

residence(钡剂流动缓慢或一过性滞留)Limitingfillingdefect(局限性充盈缺损)（Carcinomaoccurmostfrequent）DifferentialdiagnosisThelowersegmentCavitylumpoccurred.Esophageal

wallcircularorirregularthickening(>5mm).Mushroomtype(蕈伞型)Whenthetumor

invade

thetrachea,tracheoesophagealfistula(气管食管瘘)Singleor

multiplesmall

niches(龛影)Thesurroundingofthetumorbecomebulged,andthefoldsofmucousbecomedamaged.Esophagealvarices(食管静脉曲张)3SectionsoftheesophagusEnhancedscanningIntermittent

dysphagia(间歇性吞咽困难)Bariumstream

slowor

temporary

residence(钡剂流动缓慢或一过性滞留)Limitingfillingdefect(局限性充盈缺损)MagneticResonanceImaging(MR)Cachexia(恶病质)Cavitylumpoccurred.Symptomsareoftennotobvious,butwhenswallowingthecoarsefood,differentdegreesofuncomfortablefeelingsmayoccur.Ulcerativetype(溃疡型)ThemiddlesegmentInearlystageLimitingfillingdefect(局限性充盈缺损)Nitrosamines

contentofthese

foods

areveryhighClassificationofesophageal

cancerAnatomyoftheEsophagusMiddleandadvancedstageCavitylumpoccurred.Esophagealvarices(食管静脉曲张)ThelowersegmentMushroomtype(蕈伞型)ThemiddlesegmentWithoutmucosalfoldbreak