Most of the growth of malignant tumors through direct invasion, lymphatic spread and hematogenous spread in three ways. Esophageal cancer patients is no exception. Among them, the direct invasion and lymph node metastasis is more common, hematogenous spread of patients less.
The spread of esophageal cancer and metastasis 1. Directly announcer and infiltration
Esophagus directly spread, first appeared in the esophageal mucosa or submucosa, because of esophageal mucosa and submucosa is rich in lymph nodes the network, when the carcinoma cell invasion and lymph after the lower esophageal mucosa, along the esophageal lamina propria or submucosa to the lymphatic infiltration, the surface was pale or small nodules. Most of the mucous membrane element with the naked eye spread markedly abnormal, and only microscopic examination can be confirmed. Nodules along the lymphatic spread, resembles the second primary cancers, such diffusion within the esophageal wall, and sometimes from the primary tumor 5_6cm, so the length of the adequacy of surgical resection is very important.
No esophageal serosa by the tumor involving the muscular esophagus, it is easy through direct infiltration of loose connective tissue adjacent organs. According to different parts, it is different organs involved. On the formation of esophageal cancer can be invasive esophageal tracheal bronchus thin, but also invading the thoracic duct, azygos vein, hilum, a small number of cases of cancer invasion and the formation of aortic arch aorta thin, leading to bleeding death; lower esophageal cancer can be invaded and pericardium, breast muscle , responsible for the door and the left lobe of the liver. Aortic elastic membrane and the vertebral body resist film on the infiltration of a certain role. Generally believed that the direct spread of most cancers in the previous paragraph, at least the following paragraph.
Dissemination and metastasis of esophageal carcinoma 2. Lymph node metastasis
Lymph node metastasis of the esophagus is more common, generally considered poorly differentiated esophageal squamous cell carcinoma or undifferentiated carcinoma of lymph node metastasis early, metastatic sites and the lymphatic drainage patterns on the esophagus, upper esophageal carcinoma may invade the esophagus, throat, the neck and supraclavicular lymph nodes deep If there are hoarseness, and more oppressive as the recurrent laryngeal nerve lymph node metastasis. Esophageal cancer often occurs near the middle of the esophagus or hilar lymph node metastasis can be up or down. Pericardial paraneoplastic lower abdominal lymph nodes, even up the transfer of first visible vertical breast or cervical supraclavicular lymph nodes, lymph node showed "skip metastasis" phenomenon.
Dissemination and metastasis of esophageal 3. Hematogenous metastasis
Hematogenous metastasis of esophageal cancer is less common, occurring in advanced cases of the metastatic site followed by liver, hilar, bone, kidney, adrenal gland, pleura, so as to liver and lung is more common in the autopsy in 1 / 3 of the esophagus of patients local disease has always been more limited, local complications due to obstruction, airway thin, bleeding, cachexia and other deaths, so the esophageal cancer patients after combined therapy, many patients can achieve good results.
- patterns of lymph node infintration esophageus