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Objective@#To investigate the risk factors and survival status of hypopharyngeal carcinoma with synchronous second primary carcinoma of the esophagus.@*Methods@#One hundred and sixty patients with newly diagnosed hypopharyngeal carcinoma from January 2009 to December 2012 were retrospectively reviewed. The clinical data, tumor-related information and follow-up results were collected and analyzed.@*Results@#Forty-three synchronous esophageal carcinomas (27%) were detected in 160 patients with hypopharyngeal carcinoma, and most patients (72%) were at an early stage. On univariate analysis, the median age of less than 55 years old (χ2=4.525, P=0.033), excessive alcohol consumption (χ2=6.942, P=0.008) and invasion site more than 3 anatomical regions (χ2=21.503, P=0.000) had a significant correlation with the occurrence of synchronous esophageal carcinomas. Multivariate analysis showed that excessive alcohol consumption (OR=4.787, P=0.029) and invasion site more than 3 anatomical regions (OR=14.391, P=0.000) were independent risk factors. The median survival time was 26 months in 43 patients with synchronous esophageal carcinomas, which was significantly lower than that (58 months) in patients without secondary primary esophageal carcinomas (χ2=11.981, P=0.001).@*Conclusions@#There is a high incidence of synchronous esophageal carcinoma in hypopharyngeal carcinoma patients, affecting the prognosis of hypopharyngeal carcinoma. Surveillance for esophageal carcinomas in patients with hypopharyngeal carcinoma, especially in excessive alcohol drinkers, is warranted.
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Objective To assess the clinical value of endoscopic uhrasonography(EUS)combined with the mini-probe endoscopic uhrasonography(MPUS)in determing tumor invasion depth and lymph node metastases of early superficial esophageal cancer.Methods One hundred and twenty-four superficial esophageal cancer lesions of 121 patients were staged by EUS combined with MPUS,and the results were finally compared with pathological findings of surgical specimens or samples obtained by mucosal resection.Results The diagnostic accuracy of EUS in T staging of superficial esophageal cancer was 82.3%(102/124).The total ratio of lymph node metastases was 5.0%(6/121),with no node metastases in carcinoma in situ,1.3%(1/28)in mucosal carcinoma,11.6%(5/43)in submucosal carcinoma.Conclusion EUS combined with MPUS is accurate in staging of the superficial carcinoma,which can help the choice of therapeutic strategies.
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Objective To evaluate the efficacy of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) in diagnosis of enlarged mediastinal lymph nodes (LNs), mediastinal occupying lesion of unknown origin, as well as in N-staging for lung cancer. Methods EUS-FNA was performed via esophagus with a 22-gange needle in 61 patients, followed by pathological and cytological examinations. Results The positive diagnosis rate of EUS-FNA was 93.4% (57/61), and the cytological and pathological diagnostic accuracy were 85.2% (52/61) and 83.6% (51/61), respectively. Of 61 patients, 26 were suspected as having lung cancer with mediastinal lymph nodes metastasis, but the bronchoscopy failed to confirm the diag-nosis. EUS-FNA diagnosed lung cancer in 21 and benign lesion in 5. Of 22 patients with mediastinal occupying lesions of unknown origin, 19 (86.4%) were diagnosed by EUS-FNA. Of 7 patients with malignant tumor history and enlarged mediastinal lymph nodes, EUS-FNA confirmed mediastinal metastasis in 6 (85.7%). Six cases of lung cancer with suspected mediastinal lymph nodes metastasis were confirmed by EUS-FNA and the corresponding therapy regimen was modified. No complications related to EUS-FNA procedure occurred. Conclusion EUS-FNA is a safe and effective method for diagnosis of enlarged medistinal LNs, mediastinal lesion of unkown origin and N-stage of lung cancer.
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Objective To evaluate the endoscopic and pathologic characteristics and etiological ex-amination of viral esophagitis. Methods The data of 16 patients with viral esophagitis, including endoscop-ic, pathological and immunohistochemical findings were retrospectively studied. Results Endoscopic find-ings of viral esophagitis were characterized by single or multiple round and oval ulcers, located at the upper and middle esophagus. The surface of the ulcer was clean, and the boundary was distinct. Pathologic findings included degeneration and necrosis in squamons epithelium, accompanied by ulcer, infiltration of neutrophils and lymphocytes, hyperplasia of capillaries and basal cells and formation of granulation tissues, Immunocyto-chemical examination showed HSV-1 was positive in biopses, while CMV, EBV, HHV8 were negetive. Con-dusion Viral esophagtitis exhibited distinctive endosoopic and pathological features, and etiology can be confirmed by immunohistochemical examinations.
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OBJECTIVE To investigate the characteristics of hypopharyngeal carcinoma detected by narrow band imaging(NBI)endoscopy and evaluate the value of NBI in the early diagnosis of hypopharyngeal carcinoma. METHODS Between December 2008 and July 2009,a total of 46 consecutive patients with hypopharyngeal squamous cell carcinoma were enrolled in this study. High performance endoscopic system equipped with the white light mode and NBI mode was introduced in the examination of pharynx and larynx. The quality of visualization of morphologies of epithelial capillary and demarcation line of each lesion under NBI view was evaluated in comparison with conventional white light endoscopy. RESULTS Among the 46 patients,a total of 86 lesions were detected. The notable characteristic of hypopharyngeal squamous cell carcinoma is the well demarcated brownish area and scattered brown dots. The NBI laryngoscope could provide better visualization of morphologies of epithelial capillary and demarcation line in superficial carcinoma of hypopharynx than the white light mode(P
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<p><b>OBJECTIVE</b>Endoscopy was used to study the high incidence area of cancer of gastric cardia.</p><p><b>METHODS</b>417 patients with early cardiac cancer and 451 patients with advanced lesions were analyzed to the high incidence point of cardiac cancer. Verifying endoscopic screening of 205 subjects was performed later in the high incidence area of esophageal cancer.</p><p><b>RESULTS</b>327 of 417 (78.4%) of early cardiac cancer patients and 336 of 451 (74.5%) of advanced lesions were proved to have developed their origin at the root of the mucosal fold in the gastric cardia. Eleven cardiac cancer patients were found by the verifying endoscopic screening, among whom 9 patients (81.8%) developed the primary focus at the root of mucosal fold in the cardia.</p><p><b>CONCLUSION</b>The root of mucosal fold in the gastric cardia is proved to be the high incidence point of cancer of gastric cardia, which is very important clinically.</p>
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Humans , China , Epidemiology , Gastroscopy , Methods , Incidence , Stomach Neoplasms , Classification , Diagnosis , Epidemiology , PathologyABSTRACT
Objective To evaluate the application and effect of endoscopic screening directly with i-odine stain in high risked area of esophageal cancer and compare the detecting rate of cancer and dysplasia before and after iodine stains. Methods In the high risked area of esophageal cancer, endoscopic exam were directly performed in 3 022 people, aged 40 - 69 years with iodine staining and biopsy, then observing and recording the alternation of color and morphology of mucbsa and texture of submucosal blood vessels before and after iodine staining. Results One hundred and thirty one cases of esophageal carcinoma and 659 cases of moderate and severe dysplasia were diagnosed by biopsy; the discovery of esophageal cancer before and after iodine stain were 57 ( 1. 9% ) and 111(3.7%) cases, while of moderate and severe dysplasia were 154(5. 0% ) and 659(21. 8% ) cases respectively with significant statistical differences. Conclusion The mucosal iodine staining under endoscopy markedly increased the detecting rates of early superficial esophageal cancer and dysplasia ( moderate and severe) .