Esophageal cancer called esophageal cancer, occurs in the esophageal epithelium of the malignant tumor, accounting for 2% of all malignant tumors. Each year about 22 million people worldwide died of esophageal cancer, esophageal cancer in China is a high incidence of deaths due to esophageal cancer, gastric cancer ranks second only to the age of onset more than 40 years of age, more men than women, but in recent years onset 40 years of age who have growth trend. The incidence of esophageal cancer and chronic stimulation of nitrosamines, inflammation and trauma, genetic factors as well as drinking water, food and related trace elements in vegetables.
In the world, high incidence of the following areas: Kazakhstan Guliyafu, northern Iran, Turkmenistan, South Africa, Transue open so, the incidence rate of more than 100/10 million.
First, the early symptoms of esophageal cancer
1. Swallow choking feeling stems up to see, can choose the disappearance and relapse, does not affect the eating. Mood swings often occur when the patient, it is easily mistaken for functional symptoms.
2. Retrosternal pain and were more common under the xiphoid. When swallowing or chest pain under the xiphoid, was burning in nature can be like, needle-like or drawing of samples in order to swallow rough, hot or spicy food as a. Was intermittent at first, when the cancer has invaded nearby tissue, or penetrating, the can have severe and persistent pain. Location of the pain often is not fully consistent with esophageal lesions. Pain, antispasmodic agents can be more than temporary relief.
3. Food stranded infection and foreign body sensation when swallowing food or water, some food and stay slow down the feeling, and chest tightening feeling in the esophagus or food, such as adhesion feeling fresh graduates disappear. The site of symptoms more consistent with esophageal lesions.
4. Throat swallow dry and tight feeling especially dry, rough food, the occurrence of this symptom often associated with the patient's emotional fluctuations.
5. Other symptoms of a small number of patients may have chest discomfort Fullness, before symptoms such as pain and He gas.
Second, the medium-term symptoms of esophageal cancer
1. Swallow choking feeling stems up to see, can choose the disappearance and relapse, does not affect the eating. Mood swings often occur when the patient, it is easily mistaken for functional symptoms.
2. Retrosternal pain and were more common under the xiphoid. When swallowing or chest pain under the xiphoid, was hot like its nature can be, like needle-like or pull to swallow rough, hot or spicy food as a. Was intermittent at first, when the cancer has invaded nearby tissue, or penetrating, the can have severe and persistent pain. Location of the pain often is not fully consistent with esophageal lesions. Pain, antispasmodic agents can be more than temporary relief.
3. Food stranded infection and foreign body sensation when swallowing food or water, some food and stay slow down the feeling, and chest tightening feeling in the esophagus or food, such as adhesion feeling fresh graduates disappear. The site of symptoms more consistent with esophageal lesions.
4. Throat swallow dry and tight feeling especially dry, rough food, the occurrence of this symptom often associated with the patient's emotional fluctuations.
5. Other symptoms of a small number of patients may have chest discomfort Fullness, before symptoms such as pain and He gas.
The typical mid-esophageal symptoms: progressive dysphagia. May have chest pain when swallowing and spit phlegm mucus samples.
Third, the symptoms of advanced esophageal cancer
1. Dysphagia, progressive dysphagia treatment when the vast majority of patients the main symptom, but it is late in the disease of the performance. Because the esophageal wall and expansion of flexible capacity, only when about 2 / 3 of the esophageal circumference is infiltrated cancer only when there dysphagia. Therefore, in the early symptoms appear, the disease within a few months gradually increase, from the development can not swallow solid food to liquid food can not swallow. Such as esophagus cancer associated with inflammation, edema, convulsions, etc., can aggravate dysphagia. Sense of position blocking tumor parts are often found hand.
2. Food reaction often occurs when increased dysphagia, regurgitation is not, containing food and mucus, but also containing blood and pus.
3. Other symptoms when cancer can cause hoarseness, recurrent laryngeal nerve compression; violations of hiccup can cause phrenic nerve or the phrenic nerve palsy; compression of the trachea or bronchus, there may be shortness of breath and dry cough; erosion can be lethal aortic bleeding. Concurrent esophageal - tracheal or esophageal - bronchial fistula, or cancer in the upper esophagus, the swallowing of liquid often produces symptoms of cervical sympathetic paralysis group.
Fourth, signs
Early signs to be absent. Can occur late hit uh, difficulty in swallowing. And because of malnutrition in patients with swallowing difficulties can lead to the emergence of weight loss, anemia, dehydration or other signs of cachexia. When the cancer metastasis, it can hit hard swelling of the superficial lymph nodes, or liver enlargement and nodular. Also jaundice, ascites. There are other signs of a rare skin, abdominal white line at the nodes, groin lymph nodes.
Five complications of esophageal cancer
1. Cachexia in advanced cases, due to increasing dysphagia, resulting in chronic hunger lead to negative nitrogen balance and weight loss, postoperative complications of esophageal cancer incidence and mortality have a direct impact. Virtually every 1 patient had obstructive symptoms of advanced esophageal cancer patients have difficulty eating because of oral, there are varying degrees of dehydration and reduction of total body fluids. Patients with cachexia and significant water loss, showing a high degree of weight loss, weakness, loose skin and dry, was exhaustion.
2. Bleeding or vomiting blood, vomiting part of esophageal cancer patients, individual patients due to tumor invasion of esophageal cancer with hematemesis great vessels, with occasional bleeding. According to Wu Ying Kai and Huang Guojun (1974) reported that a group of 841 cases of ESCC and GCA patients, 24 patients (2.8%) had vomiting blood, blood from esophageal cancer, ulcers, lung or breast cancer within the erosion of large vessels. Vomiting is usually the patient's clinical symptoms of advanced esophageal cancer.
3. Metastasis, if the lung, liver, brain and other vital organs shift, possible breathing difficulties, jaundice, ascites, coma, and other relevant organs of the specific symptoms. In case of esophageal cancer esophageal - tracheal fistula, supraclavicular lymph node metastasis and other organ metastasis, recurrent laryngeal nerve paralysis and cachexia, and both are advanced.
4. Sympathectomy sympathetic ganglion compression tumor suppression, the resulting sympathetic paralysis (Homer syndrome).
5. Water, electrolyte imbalance due to swallowing difficulties such patients have severe hypokalemia and muscle weakness trend. Normal secretion of saliva a day about 1 to 2 liters, of which the inorganic substances, including sodium, potassium, calcium and chlorine. The concentration of potassium in saliva than any other gastrointestinal secretions of potassium concentration, usually 20mmol/ml. Therefore, the esophageal cancer patients is not due to swallowing difficulties, swallowing saliva, you can see significant hypokalemia.
Some squamous cell carcinoma can produce parathyroid hormone caused by hypercalcemia, even though the patient in the absence of bone metastases can also be a case of hypercalcemia. Preoperative esophageal cancer patients without bone metastasis had hypercalcemia, often a sign indicating a poor prognosis.
6. Esophageal obstruction because of aspiration pneumonia caused by aspiration and aspiration pneumonia, the patient may have fever and systemic symptoms of poisoning.
7. Caused by cancer metastasis, such as recurrent laryngeal nerve invasion of tumors caused by vocal cord paralysis and hoarseness; tumor suppression and violation of the trachea, bronchial irritation due to shortness of breath and dry cough; violations of the phrenic nerve, causing paralysis of the diaphragm; violations of the vagus nerve, the heart rate acceleration; violation of the brachial plexus, causing acid arm, pain, paresthesia; oppression of the superior vena cava, causing superior vena cava syndrome; liver, lung, brain metastases and other important organs, can cause jaundice, ascites, liver failure difficulty breathing, coma and other complications.
8. Esophageal perforation: advanced esophageal cancer, especially esophageal ulcer due to local tumor ulceration caused severe erosion and perforation. Perforation of adjacent organs due to the different parts and different symptoms. Caused by penetrating tracheal esophageal fistula, into the diet appears choking anatomy, especially when the symptoms into the liquid diet; penetration can cause mediastinitis mediastinum, the occurrence of chest tightness, chest pain, cough, fever, heart rate, and leukocytosis, etc. ; wearing human lung caused by lung abscess, high fever, cough, slightly purulent sputum, etc.; penetrating the aorta, causing aortic esophageal fistula, can cause bleeding and death.
9. Other reported in the literature, some of esophageal squamous cell carcinoma with hypertrophic osteoarthropathy, and some patients with esophageal cancer associated with dermatomyositis hidden, there are individual patients with esophageal cavity obstruction occurred "swallow syncope" may be a vagus nerve - the media reaction.
