Esophageal cancer is a malignant tumor occurring in the epithelial tissue of esophagus, accounting for about 3% of all malignant tumors, and is one of the common malignant tumors in human beings. China is a high incidence area of esophageal cancer, and the incidence age is mostly above 40 years old, and more men than women. The occurrence of esophageal cancer is related to the chronic stimulation of nitrosamines, inflammation and trauma, genetic factors and the content of trace elements in drinking water, food and vegetables.
I. Clinical symptoms of esophageal cancer
Early esophageal cancer has no specific symptom, and swallowing difficulty appears only when there is obvious narrowing. Most patients do not pay attention to it and delay the disease. Therefore, early detection and early treatment is the key.
1.Common early manifestations.
★ Dryness and tightness in the throat, especially when swallowing dry and rough food.
★ Food retention or foreign body sensation, when swallowing food or drinking water, there is a feeling of food going down slowly and stagnant.
★ A feeling of tightness and stuffiness behind the sternum, and a feeling of choking in the throat. When swallowing food, there is pain behind the sternum or under the raphe, which may be burning, pinching or pulling, or frictional pain, and it is more prominent when swallowing rough, burning or irritating food.
2.Middle stage
★ Typical symptoms are progressive dysphagia, first it is difficult to swallow dry food, followed by semi-liquid, and finally water and saliva can not be swallowed.
★ Often spitting mucus-like sputum, which is the secretion of saliva and esophagus from the lower throat.
★ Gradual wasting, dehydration, and weakness. Persistent chest pain or back pain is indicated as an advanced symptom.
3.Concomitant symptoms
★ Hoarseness. Invasion or compression of laryngeal nerve by cancer or lymph nodes may cause paralysis of vocal cords, resulting in hoarseness.
★ Neck and/or supraclavicular mass, which is a more common site of lymph node metastasis in esophageal cancer.
★ Invasion of phrenic nerve may cause erratic or phrenic nerve palsy; compression of trachea or bronchus may cause shortness of breath and dry cough; erosion of aorta may produce fatal bleeding.
If the cancer is located in the upper esophagus or complicated with esophage-trachea or esophage-bronchial fistula, cervical sympathetic nerve palsy syndrome is often produced when swallowing liquid.
Early examination of esophageal cancer
1.Esophageal exfoliative cytology examination is the preferred method for early diagnosis of esophageal cancer. It has been proved through practice that it is feasible to conduct large area screening in high incidence area of esophageal cancer, and the total positive rate can reach more than 90%.
2.Barium X-ray meal imaging This method can detect the changes of esophageal mucosa, structure and function at an early stage, which can help to judge the precancerous lesions of esophagus at an early stage.
3.Fiber endoscopy has become a reliable method for routine clinical diagnosis, postoperative follow-up and efficacy observation of upper gastrointestinal diseases (esophageal cancer, gastric cancer, etc.). In early esophageal cancer, the detection rate of fiberoptic endoscopy can reach more than 85%.
4.CT scan of chest It is helpful for staging of esophageal cancer, determination of resection possibility and estimation of prognosis.