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Background: Oesophageal carcinoma is one of the leading causes of cancer related deaths worldwide and is also associated with high morbidity. Hence early diagnosis and treatment are the only effective way to improve survival and quality of life in oesophageal carcinoma patients. Early-stage oesophageal carcinoma are often asymptomatic and may also present with common upper gastrointestinal symptoms hence diagnosis of early oesophageal carcinoma is only based on detection of suspicious lesions through endoscopy and histopathological evaluation of biopsies from these suspicious lesions. The study is designed to see whether using alarming upper gastrointestinal symptoms, risk of oesophageal carcinoma in patients can be predicted.Methods: Present study comprises of 200 patients presenting with upper gastrointestinal symptoms at JSS Hospital, Chamarajanagar (both out patients and referred patients) during the period of October 2018 to December 2019, who underwent upper gastrointestinal endoscopy.Results: Out of 200 patients, 135 patients were males and 65 patients were females. According to the study, dysphagia was found to be a significant predictive factor and in contrary to the global statistics this study showed females aged more than 60 years were significantly at higher risk of developing oesophageal carcinoma.Conclusions: We recommend to do an early endoscopy for any patient presenting with upper gastrointestinal symptoms and to take multiple biopsies from any suspicious lesion especially for male gender older than 50 years and female gender older than 60 years presenting with dysphagia.
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ABSTRACT: A 9-year-old male Shih Tzu dog presented with a mass on the ventral region of the neck and developed ptyalism. Radiographs revealed a radiodense nodule located in the mid-third of the oesophagus compressing the trachea. Preoperative cytology showed large neoplastic cells with abundant vacuolated cytoplasm arranged in clusters. The nodule was removed by oesophagectomy and submitted for histopathology. Microscopically, the oesophageal mass was multilobulated and unencapsulated. It had a mixed cellular growth pattern with areas showing squamous and glandular differentiation. The squamous component of the tumor was formed by solid strands of neoplastic epithelial cells; many neoplastic cells had undergone central keratinization and sometimes formed keratin pearls. The deeper adenocarcinomatous portion of the tumor consisted of tubules filled with slightly basophilic mucinous material. Histological and immunohistochemical examination confirmed the diagnosis of primary adenosquamous carcinoma (ASC) of the esophagus. This is the first report of primary ASC of the cervical oesophagus in a dog.
RESUMO: Um cão Shih Tzu de nove anos de idade apresentou uma massa na região ventral do pescoço e desenvolveu ptialismo. As radiografias revelaram um nódulo radiodenso localizado no terço médio do esôfago que comprimia a traqueia. A citologia pré-operatória mostrou células neoplásicas grandes com citoplasma vacuolizado abundante, dispostas em aglomerados. O nódulo foi removido por esofagectomia e submetido à histopatologia. Microscopicamente, a massa esofágica era multilobulada e não encapsulada. Apresentava um padrão de crescimento celular misto, com áreas mostrando diferenciação escamosa e áreas de diferenciação glandular. O componente escamoso do tumor era formado por filamentos sólidos de células epiteliais neoplásicas; muitas células neoplásicas demonstravam queratinização central e, por vezes, formavam pérolas de queratina. A porção adenocarcinomatosa mais profunda do tumor consistia em túbulos preenchidos com material mucinoso levemente basofílico. O exame histológico e imunohistoquímico confirmaram o diagnóstico de carcinoma adenoescamoso primário do esôfago. No conhecimento dos autores, este é o primeiro relato de carcinoma adenoescamoso primário do esôfago cervical em um cão.
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Introduction: CT has become a useful diagnostic modality in the evaluation of the stage of oesophageal carcinoma and an integral part of surgical planning. Present study describes various finding of oesophageal carcinoma on CTto aid in its diagnosis and staging. Aim and objectives: The aim of our study is to evaluate and describe the various CT findings of carcinoma oesophagus to evaluate diagnostic accuracy of CT for carcinoma oesophagus and comparision of CT findings with histopathological findings to stage the disease using worldwide accepted criteria of TNM staging system. Materials and Methods: After ethical clearance, a prospective study was carried out in the Gujarat Cancer and Research In statute, Ahmedabad, from August 2015 to November 2017. After obtaining consent, 100 patients presenting with clinical symptoms and signs pertaining to carcinoma of oesophagus were studied. Oral and IV contrast was used. Three dimensional reconstructions were done and various CT findings of oesophageal cancer studied. The diagnosis and staging confirmed by post-operative histopathology. Results: Carcinoma oesophagus was commonly seen in age group between 51 to 60 years (34%) with males (72%) more commonly affected than females (28%). All patients predominantly presented with dysphagia. The middle 1/3rd of oesophagus affected more commonly compare to other parts. The wall thickness in majority of the cases measured between 10-20mm (62%). T3N1M0 was the most common staging found in CT (30%). 16% cases presented with metastasis. Squamous cell carcinoma (84%) was the most common histopathological type presented. 54 patients got operated out of 100 and CT staging was compared with the postoperative histopathological staging. The accuracy of CT-scan for 'T' stage were 83.33 %, in 'N' stage 81.48 % and in 'M' stage being 99 %. Conclusion: CT-scan is excellent in the diagnosis of distant metastasis and lymphadenopathies. Thus, evaluation of various CT findings and preoperative staging of carcinoma oesophagus will help to decide management of these patients. Hence, CT plays an important role in detecting and staging carcinoma oesophagus.
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Objective To investigate the effect of propofol on the expression of VEGF in Oesophageal carcinoma cells EC9706 and its related molecular mechanism.Methods The expression of VEGF in human Oesophageal carcinoma cells EC9706 and normal esophageal epithelium cells HEEC were compared by immunoblotting.EC9706 was treated with different concentrations of propofol (0,2,6,10μg/L).After incubation,the EC9706 cell lines were detected with MTT,flow cytometry,cell invasion and cell scratch tests.The expression of VEGF,and the phosphorylation of p38 (MAPK) and p44/42 (ERK1/2) were detected by qRT-PCR and immunoblotting in each group.Results The expression of VEGF in EC9706 cells was significantly higher than that in HEEC cells.After propofol intervention,the proliferation,migration and invasion of propofol groups were significantly lower than that of Ctrl group,while the apoptotic rate of propofol groups were significantly higher than that of Ctrl group.The expression of VEGF mRNA and protein in propofol groups were significantly lower than that in Ctrl group.The expression and phosphorylation of p38 (MAPK) and p44 / 42 (ERK1 / 2) were inhibited by propofol.Both of these effects were dose-dependent.Conclusion Propofol inhibits the proliferation,invasion and migration of OC cells EC9706 and promotes apoptosis.Its potential mechanism may work by inhibiting the MAPK/ERK signaling pathway,thereby inhibiting VEGF expression.
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Oesophageal Carcinoma presenting as symptoms of acute respiratory distress is extremely rare. Hence diagnosis may be difficult as all the initial investigations are focused towards finding a respiratory cause. In this paper the authors report a 62 year old Caucasian male who presented with acute dyspnoea with no respiratory history but was subsequently discovered to have an oesophageal carcinoma as the likely underlying cause. Subsequent investigations revealed it to be a stage IB squamous cell midoesophageal carcinoma that was treated by radiotherapy. It is important when evaluating a patient with acute respiratory symptoms but no previous respiratory history to consider alternative pathologies related to surrounding anatomical structures also.
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A review of 10 patients who underwent substernal gastric bypass with oesophageal exclusion for palliative treatment of carcinoma of the oesophagus is presented. The patients were old (average 67.3 years.); all had pulmonary problems or unresectable oesophageal carcinoma. There was anastomotic leakage in 2 cases. Blowout of oesophageal stump occurred in 4 cases: two at the upper oesophagus and two at the lower oesophagus. Five patients died in the hospital, one from subdiaphramatic abscess, one from aspiration of contrast media, and the others died from progressive cachexia. The longest survival was 18 months in one patient.