How to diagnose esophageal cancer, which many patients and their families concerns, generally the most commonly used X-ray barium meal examination, cytology, three kinds of fiber optic endoscopy. Advances in technology along with chest CT scan, esophageal endoscopic ultrasonography and other units in a premise has also been used clinically. Clinical practice should be from simple to complex order, the first three checks are essential, especially in fiber endoscopy.
How to diagnose esophageal cancer 1, X-ray barium contrast X-ray barium contrast is the primary means of cardiac diagnosis. Early mucosal changes in the performance of the subtle, small ulcers Kanying and there is not significant and constant filling defect. In the early cases, fiberoptic endoscopy must be combined brushing cytology and biopsy, before they can confirm the diagnosis. X ray findings clearly advanced cases, including soft tissue, mucous membrane damage, ulcers, Kan Ying, filling defect, cardiac narrow channel distortion, the lower esophageal involvement, and size of bending the body of stomach fundus stomach infiltrating Jieyou how stiff the stomach smaller in size diagnosis of esophageal cancer 2, esophageal endoscopic ultrasonography in recent years, endoscopic esophageal ultrasound (EUS) progressive clinical application. However, because equipment is expensive, in the foreseeable future will not be widely adopted. EUS the event of a system to work by filling water bladders, a layer of normal mucosa Lower Dir is an echo occurs, the second layer of muscularis mucosa is a dark area, the third layer of mucous membrane under the echo.
3 how to diagnose esophageal cancer, esophageal cytology of esophageal cytology method is simple, less painful subjects, the false positive rate, practice proved to survey a large area in the high incidence of the most practical method, the total positive The detection rate of 90% (esophageal cancer 94.2%, 82.1% Ben cancer), false positive rate of less than 1%, the false negative rate of 10% . Some of the times taken to sub-netting, to locate, such as positive when more than 25cm from the incisors subtotal esophageal, neck reconstruction, 25 ~ 35cm between the most positive for esophageal resection and reconstruction of the bow, 35cm the following when the arch resection and reconstruction. Cytology positive rates in advanced cases, anti declined. This is because the heavy nets through nothing more than a narrow segment of tumor Erzhi, worth noting. Cytology contraindication for hypertension, esophageal varices, severe heart and lung disease.
How to diagnose esophageal cancer 4, fiber esophageal endoscopy study mirror from the 70s to gradually replace the metal fiber tube lens has desirable because of its freedom of flexible patient positioning, good lighting, wide viewing angle (and slightly larger), it greatly progressed Check the security and accuracy.
The indications of esophageal endoscopy fiber are: the early symptoms of patients with asymptomatic or slightly. Without the discovery of X-positive when positive cytology. X ray findings and difficult to distinguish benign lesions, such as wall symmetry, similar to benign smooth narrow scar stenosis or submucosal fibroids as wall lesions. benign esophageal lesions had been diagnosed as diverticular disease or cardiac failure relaxation, when the symptoms were significantly increased. all treated patients have received follow-up effects were observed.
5, how to diagnose esophageal cancer, chest CT in the diagnosis and treatment of chest CT in the diagnosis and treatment of esophageal cancer in the role of the evaluation of each different, some think that CT for staging and resection possible to determine, are helping the estimated prognosis. But there is no such inspection that the role of the speech there, CT staging was only 60% correct. CT to determine lymph node metastasis, lymph node metastasis in esophageal agility around 60%, and abdominal lymph node metastasis was 76% higher agility, and its specificity was 93%. Agility determine the liver CT was 78%, specificity of 100%.
Objective analysis, CT findings can not discriminate between normal lymph node metastasis size, can not be sure because of inflammation or swelling of lymph node metastasis caused, but can not find that the transfer of lymph node diameter of less than 1cm. As noted above, foreign invasion and organs to determine the accuracy is limited, so CT can not be simply a "positive findings" and discard the chance of operation.