性激素在食管、贲门癌发病中的变化及临床意义

探讨性激素在食管，贲门癌发病中的作用及临床意义。方法应用放射免疫法对３０例食管，贲门部良性疾病，４０例食管癌患者，１０例贲门癌患者血清睾酮及雌二醇水平进行测定。     

食管、贲门癌外科疗效分析

我院胸外科自1979年1月~2004年12月行外科手术治疗食管、贲门癌2676例,其中食管癌1667例,贲门癌1009例,现报告如下。1资料与方法1.1一般资料:本组2676例,男1682例,女994例,年龄24~80岁,平均53岁,50~65岁多见,占87.5%。2676均有不同程度吞咽食物梗噎感、胸骨后疼痛及闷胀不适感。从出现症状到确诊时间最长12个月,最短半个月,平均4.5个月。TNM分期:0~Ⅰ期826例,Ⅱ~Ⅲ期1352例,Ⅳ期498例。上段食管癌423例,中段食管癌1296例,下段食管癌528例,贲门癌429例。1.2治疗方法:本组1667例食管癌,手术切除1532例,切除率91%;贲门癌1009例,切除283例,切…     

食管癌和贲门癌外科治疗进展—9107例资料分析

从１９６５年４月至１９９０年１２月我们对９１０７例食管癌和贲门癌病人进行外科治疗，其中食管癌６４２８例，贲门癌２６７９例。现重点比分析２５年间前１４年（１９６５－１９７９，Ａ组）和后１１年（１９７９－１９９０年，Ｂ组）的资料，以评价外科治疗的。总切除率为９０．１％，食管癌和贲门癌分别为９３．２％和８２．７％。总的５年生存率为３１．６％，食管癌和贲门癌分别为４０．３％和２０．９％。Ⅲ，Ⅳ期病例，Ａ，     

食管、贲门癌根治术后心律失常分析

目的探讨SM3、SM1、SM2和SM3期食管、贲门癌根治术术后发生心律失常的原因。方法将60~75岁且术前心电图异常的229例患者分为SM3组、SM1组和SM2/SM3组。了解其术后心率失常发生率,并比较癌症浸润不同时期术后心律失常的发生率。结果术后发生心律失常概率70%,其中59例M3,79例SM1和91例SM2/3。术后发生窦速、SM1室早和房早的总发生率(70.89%),显著高于M3组(57.62%),差异有统计学意义(P0.05)。SM2/368.13%,显著高于M3组,差异有统计学意义(P0.05)。根治术后48 h心律失常发生率78.17%(179/229例)。结论食管、贲门癌术后心律失常发生率与癌症分期有关,SM2/3SM1M3,随着癌症浸润程度的加深,术后发生心律失常的概率增加。为降低食管、贲门癌根治术术后心律失常的发生,在术前、术中和术后均需做好充分准备,有针对性做好相关防治措施。     

食管癌贲门癌不同手术方式对照

我们自 1988年 7月至 2 0 0 1年 3月共施行食管癌、贲门癌胸内手术 14 6 1例 ,其中手工吻合 5 2 7例 ,机械吻合 934例。两组手术结果表明 ,机械吻合具有操作简单、省时、可靠、并发症少等优点。现报道如下。临床资料　 14 6 1例病人中 ,男 831例 ,女 6 30例。年龄2 7～ 78岁。手工吻合组 5 2 7例 ,其中弓上吻合 2 2 9例 ,弓下吻合 2 98例 ;机械吻合组 934例 ,其中弓上吻合 5 38例 ,弓下吻合 396例。吻合器采用ＧＦ 1型 2 8号吻合器 (上海器械六厂 )、ＧＷ 2 6、2 9、32号吻合器 (常州新能源公司 ) ,另有 7例采用强生公司ＣＤＨ 2 5号吻合器…     

高龄食管贲门癌外科治疗

食管癌和贲门癌是中老年人的常见病,随着我国年龄结构的老龄化,高龄食管癌和贲门癌的发生率逐年增加.我们于1987年6月至2007年6月共收治食管癌和贲门癌患者682例,其中70岁以上高龄食管癌、贲门癌患者65例,占同期收治病例的9.5%,手术疗效满意,现将结果报告如下.     

食管憩室合并食管、贲门癌13例

食管憩室是食管常见的良性疾患 ,但合并食管、贲门癌者较为罕见。我院自 1977年 10月～ 1998年 6月共收治 13例食管憩室合并食管、贲门癌患者 ,现报告如下。1　临床资料与方法本组共 13例 ,男 8例 ,女 5例 ;年龄 36～ 6 8岁 ,平均年龄4 9.6岁。病程 3个月～ 3年 ,有不同程度的吞咽异物感 11例 ,伴吞咽疼痛、困难 8例 ,吞咽时胸骨后烧灼感 3例。食管 X线钡餐造影示 13例均表现为突出于食管腔内的半球形或囊袋状阴影 ,其中囊状阴影内壁不光滑 1例 ,囊状阴影对侧、左旁侧壁食管黏膜不光滑、僵硬、缺损 8例 ,囊状阴影下 1cm处食管黏膜充盈缺损 …     

高龄食管贲门癌切除术后并发症原因分析及护理

目前 ,外科手术仍为食管癌、贲门癌的主要治疗手段之一。随着医学各学科的发展及护理水平的不断提高 ,高龄食管、贲门癌的外科治疗适应证进一步放宽 ,并取得了较满意的效果 [1]。但由于高龄病人的病理生理特点 ,术后并发症较其它年龄组高。 1 997年 1月至 2 0 0 0年 1 2月我院对 1 1 3例高龄食管、贲门癌病人施行了外科治疗 ,术后发生近期并发症 2 2例 ,发生率 1 9.5 %。现将发生并发症的原因分析及护理介绍如下。1　临床资料1 .1　一般资料1 1 3例中 ,男 78例、女 35例 ,年龄最大 86岁 ,最小 71岁 ,中位年龄 74.0岁。其中食管癌 69例 ,贲门…     

食管内翻拔脱术治疗食管癌贲门癌19例分析

目的　探讨食管内翻拔脱术在食管癌、贲门癌外科治疗中的地位。方法　 19例食管癌、贲门癌病人接受了食管内翻拔脱术 ,其中食管鳞癌 15例 ,颈段 3例 ,胸中段 6例 ,胸下段 6例 ;贲门腺癌 4例。 0期 1例 ;Ⅰ期 4例 ;Ⅱa期 4例 ;Ⅱb期 1例 ;Ⅲ期 9例。 3例因有上消化道手术史行结肠代食管。结果　 19例均获切除 ,食管切缘阴性 ,无手术死亡。术后声音嘶哑 1例 ,心律失常1例 ,双侧胸腔积液 1例 ,左侧气胸伴左膈下脓肿 1例 ,5例出现小的颈部吻合口瘘。结论　食管内翻拔脱术扩大了食管癌、贲门癌的手术适应证 ,使某些常规手术高危患者重新获得手术机会。     

食管、贲门癌病期和术后近期对胆囊收缩功能的影响

目的为了探讨食管、贲门癌病期和术后近期对胆囊收缩功能的影响及胆结石形成的因素。方法利用多功能超声检查对５６例食管、贲门癌患者进行了研究。结果病期越晚，胆囊的收缩功能越差，Ⅰ、Ⅱａ期与Ⅳ期相比差异显著（Ｐ＜０．０５），术后近期胆囊容积大于术前（Ｐ＜０．０１），脂餐后４５分钟和９０分钟胆囊容积与脂餐前相比无差异，与术前相比差异显著（Ｐ＜０．０１）。此外，术后近期６例患者胆囊内有结石形成。结论食管、贲门癌病期和术后近期对胆囊收缩功能有较大影响，同时也是术后胆囊结石形成的重要因素。     

A Metastatic Ball Tumor in the Right Atrium Originating from Esophageal Cancer: Report of a Case

A metastatic ball tumor in the right atrium originating from esophageal cancer is extremely rare. A 53-year-old woman had two such tumors without any other types of metastasis. These tumors were associated with severe thrombocytopenia caused by the consumption of platelets. Even after repeated transfusions of platelets and fresh frozen plasma, the thrombocytopenia could not be controlled. Therefore, a surgical resection was performed to improve the thrombocytopenia and avoid sudden death due to a complete obstruction of the right ventricular outflow tract by the tumor. As the throm-bocytopenia did not recur postoperatively, the patient was discharged from hospital. She died, however, of multiple metastases with bilateral pleural effusions 5 months after the surgery.     

Multimodality Management of Esophageal Cancer

Esophageal cancer is a morbid disease with a grim prognosis. The outcomes of treatment even in non-metastatic disease undergoing potentially curative surgery are poor with 5-year survival ranging from 20 to 35 %. Several multimodality treatment options have been investigated in well-conducted randomised trials and meta-analyses evaluating both neoadjuvant and adjuvant therapies. However, there is still lack of uniform practice in the management of operable esophageal cancer. We review the current evidence for multimodality treatment of esophageal cancer, critically analysing the evidence supporting the use of each strategy, the pros and cons of each approach and discuss our approach in management. Neoadjuvant chemotherapy or chemoradiotherapy are currently the standard of care in localised esophageal cancer.     

Esophageal Cancer with a Synchronous Multiple Carcinoid of the Duodenal Bulb

Carcinoid tumors of the duodenum are relatively rare. Although they were considered benign lesions, they are now classified malignant, occasionally with poor prognosis. We report a case of esophageal cancer with a synchronous multiple carcinoid of the duodenal bulb. An upper endoscopy visualized with esophageal scan disclosed a stenotic lesion in the lower esophagus and revealed multiple 4-–5-mm-diameter masses which were on the fore wall of the duodenal bulb. The postoperative pathology report confirmed the diagnosis of esophageal squamous cancer and duodenal bulb carcinoid.     

Genetic Alterations in Esophageal Cancer

Esophageal cancer is a common malignancy with a striking variation in geographical distribution; a reflection of exposure to specific environmental factors, which are still poorly defined. We discuss the recent progress made in the investigation of the molecular biology of esophageal cancer, addressing the topics of genetic alterations, methylation, overexpression of molecules thought to cause malignant transformation, carcinogenesis, invasion, and metastasis. We review six aspects of the research literature on esophageal cancer: epidemiology and etiology, epidermal growth factor receptor and related growth factor receptors, cell cycle regulatory proteins, transforming growth factor-/Smad proteins, mismatch repair genes, and other genes. This article provides a conceptual basis for evaluating studies on the molecular mechanism of esophageal carcinogenesis and for devising therapeutic and preventive strategies based on molecular biology. We hope that in the near future, the clinical outcome of patients with esophageal carcinoma will be improved by a better understanding of the basic mechanisms of carcinogenesis.