食管癌(英文版)课件

,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,ppt课件完整,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,二级,三级,四级,五级,ppt课件完整,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,二级,三级,四级,五级,ppt课件完整,*,Carcinoma of Esophagus,Speaker:LiuRan,1,ppt课件完整,Carcinoma of Esophagus,Content,Anatomy of the Esophagus,Summary,Pathogeny(,发病机制,),Clinical feature,Diagnose,Differential diagnosis,Exercise,2,ppt课件完整,ContentAnatomy of the Esophagu,Anatomy of the Esophagus,The esophagus is a muscular tube,which is a digestive organ between the throat and stomach.,3,ppt课件完整,Anatomy of the EsophagusThe es,Physiological stenosis of esophagus,First:,The junction of the pharynx(,咽,)and esophagus.,Second,:,located in the back of left principal bronchus.,Third,:,Esophageal hiatus(,食管裂孔,).,4,ppt课件完整,Physiological stenosis of esop,3 Sections of the esophagus,The upper segment,The middle segment,（,Carcinoma occur most frequent,）,The lower segment,Tracheal bifurcation(,气管分叉,),5,ppt课件完整,3 Sections of the esophagus Th,Summary,Carcinoma of the esophagus is a common malignant tumor that occurs in a population cover 40 years old,and in predilection for male(,好发于男性,).,6,ppt课件完整,SummaryCarcinoma of the esopha,Prevalence and mortality,There are more than 300,000 people worldwide died from esophageal cancer each year,and 150,000 of them are Chinese.,7,ppt课件完整,Prevalence and mortality There,Pathogeny,1.,Nitrosamine(,亚硝胺,),2.,Fungus(,真菌,),3.,Vitamin deficiency,4.,Dietary habits,8,ppt课件完整,Pathogeny1.Nitrosamine(亚硝胺)8p,Nitrosamine,Nitrosaminescontent of thesefoodsare very high,9,ppt课件完整,NitrosamineNitrosaminesconte,Clinical feature,In early stage,Symptoms are often not obvious,but when swallowing the coarse food,different degrees of uncomfortable feelings may occur.,10,ppt课件完整,Clinical feature In early stag,Clinical feature,In the middle and advanced stage,Progressivedysphagia(,进行性吞咽困难,),When the tumorinvadethe trachea,tracheoesophageal fistula(,气管食管瘘,),Cachexia(,恶病质,),11,ppt课件完整,Clinical featureIn the middle,Classification of esophagealcancer,1.Ulcerative type(,溃疡型,),2.Mushroom type(,蕈伞型,),3.Constrictive type(,缩窄型,),4.Medullary type(,髓质型,),12,ppt课件完整,Classification of esophagealc,Diagnose,1.X-raybariummeal,2.Computed Tomography(CT),3.Magnetic Resonance Imaging(MR),13,ppt课件完整,Diagnose1.X-raybariummeal13,1.X-raybariummeal,(1).Early stage,Esophagealmucosal folds be beak(,粘膜迂曲、断裂,),Single ormultiple smallniches(,龛影,),Limiting filling defect(,局限性充盈缺损,),Barium streamslow ortemporaryresidence(,钡剂流动缓慢或一过性滞留,),14,ppt课件完整,1.X-raybariummeal(1).Early,Postoperation,Recur,15,ppt课件完整,Postoperation15ppt课件完整,Smallnodules(,小结节,),16,ppt课件完整,Smallnodules(小结节)16ppt课件完整,protrude type(,隆起型,),17,ppt课件完整,protrude type(隆起型)17ppt课件完整,Earlyulcerative type,18,ppt课件完整,Earlyulcerative type18ppt课件完整,Early constrictive type,19,ppt课件完整,Early constrictive type19ppt课,(2).Middle and advanced stage,a.Ulcerative type(,溃疡型,),niche,The surrounding of the tumor become bulged,and the folds of mucous become damaged,.(,周围隆起,粘膜皱襞破坏,),20,ppt课件完整,(2).Middle and advanced stage,Filling defect,An expand over the tumor,b.Mushroom type,21,ppt课件完整,Filling defectb.Mushroom typ,c.Constrictive type,M,63Y,Progressivedysphagia20d,22,ppt课件完整,c.Constrictive typeM,63Y,Pr,d.Medullary type,广泛侵犯食管全层,形成腔外肿物，管腔狭窄，表面可见溃疡,The carcinoma can encroach on the whole-layer of esophagus,and make a stenosis,with ulceration on it.,23,ppt课件完整,d.Medullary type广泛侵犯食管全层,形成腔外,2.CT,1.Esophagealwall circular or irregular thickening(5mm).,2.Cavity lump occurred.,3.Paraesophagealfat layerfuzzy,disappear.,4.Peripheralorgan got involvedorlymph node metastasis.,5.Enhanced scanning showedmild enhancement oftumor.,24,ppt课件完整,2.CT1.Esophagealwall circul,25,ppt课件完整,25ppt课件完整,Enhanced scanning,26,ppt课件完整,Enhanced scanning26ppt课件完整,3.MR,There is a,synechia(,黏连,),between the cancer and the aortic arch.,The high signal fat layer exist,.,27,ppt课件完整,3.MRThere is a synechia(黏连)b,Cancer invade the trachea,T2WI,：,The fat layer disappeared and the wall of trachea be damaged.,T1W enhance scanning shows a lump in the trachea and be enhanced like the carcinoma.,28,ppt课件完整,Cancer invade the tracheaT2WI：,Differential diagnosis,1.Achalasia of cardia and esophagus(,食管贲门失弛缓征,),2.Esophageal varices(,食管静脉曲张,),3.Leiomyoma of the esophagus(,食道平滑肌瘤,).,29,ppt课件完整,Differential diagnosis1.Achal,1.Achalasia of cardia and esophagus,Intermittentdysphagia(,间歇性吞咽困难,),On a widened upper segment with fluid level,Lower esophagus become thin like a beak(,鸟嘴征,),Without,mucosal fold break.,30,ppt课件完整,1.Achalasia of cardia and eso,31,ppt课件完整,31ppt课件完整,2.Esophageal varices,Have a history of liver cirrhosis,portal hypertension.,Beadedfilling defect(,串珠样充盈缺损,),Enhanced CT scanshowed vascular tortuositygroup remarkable enhancement and delayedenhancement.,Barium emptying delay,but no obstruction phenomenon.,32,ppt课件完整,2.Esophageal varicesHave a hi,33,ppt课件完整,33ppt课件完整,3.Leiomyoma of the esophagus(,食管平滑肌瘤,),Smooth circular cavity filling defect without mucosal fold break and surrounding tissue invasion and metastasis.,34,ppt课件完整,3.Leiom