Esophageal carcinoid
Introduction
Introduction to esophageal carcinoid Esophageal carcinoid (carcinoidofesophagus) originates from the neuroectodermal layer and mainly occurs in the digestive tract, accounting for 0.87% of malignant tumors of the digestive tract. It is a tumor of the Apudo (proteotropin-producing hormone) tumor, also known as argyrophiloma or chromaffin. Cell tumor. basic knowledge The proportion of illness: 0.1% - 0.2% Susceptible people: no special people Mode of infection: non-infectious Complications: esophageal cancer
Cause
Esophageal carcinoid cause
Cause:
There are scattered argyrophil cells (Kulchitsky cells) in the base of normal esophageal mucosa. Esophageal carcinoids are caused by malignant transformation of argyrophil cells in the bottom of esophageal mucosa. It is a low-grade malignant neuroendocrine tumor and belongs to diffuse neuroendocrine system (diffuse). Neuroendocrine system (DNS), its general pathological manifestations are polypoid or nodular ulcer type, the size is 0.7 ~ 12cm, the tumor margin is clear, the texture is tough, grayish white, nodular ulceration often indicates that the carcinoid is in the middle and late stage, under the microscope The morphology of tumor cells is relatively uniform, and the cell boundaries are mostly clear. The tumor cells are arranged in a strip-like shape, solid flaky, partially glandular or acinar, but no obvious lumen, round or elliptical, densely chromatin. The nucleolus is rare, the mitosis is less, the cytoplasm is less, the acidophilus is slightly, and the cytoplasm is more abundant. The silver stained granules can be seen. The immunohistochemical examination of the tumor cytoplasm can show the neuro-specific enolase (NSE), chromogranin (chromogranin). And serotonin-positive, tumor cells aggregate, surrounded by unequal amount of connective tissue surrounding, interstitial rich in sinusoids, due to argyrophilic cells more common in food Middle and lower mucosa, so esophageal carcinoid tumors occur in the lower esophagus.
Prevention
Esophageal cancer prevention
1. Water is the source of life. It is also one of the main sources of carcinogenic nitrosamines entering the human body. Therefore, we must use water sources with water quality guarantee; do not drink thousands of boiling water or overnight water in life; farmland pays attention to rational fertilization, formula Do not use nitrate fertilizer too much for fertilization.
2, high-risk areas of esophageal cancer, such as Henan, Jiangsu, Shanxi, Hebei, Fujian and other places to actively participate in the esophageal cancer screening, early detection and early treatment.
3, strengthen the preservation of food, anti-mold and detoxification, do not eat rotten and deteriorated food, like wheat, corn, peanuts are prone to mold, must be properly placed. Eat more fresh fruits and vegetables, eggs, milk and appropriate amount of lean meat, increase the intake of vitamin C, vitamin E, -carotene; honey, garlic, green tea have anti-cancer effect, you can eat some of these foods.
4, people with obvious family history of esophageal cancer and genetic susceptibility should be more vigilant, must consciously establish a sense of prevention, regularly go to the hospital for examination, so as not to delay treatment.
5, should pay attention to the treatment of benign esophageal diseases, such as esophagitis, achalasia, scarring, especially in the timely detection and treatment of esophageal cancer lesions - esophageal mucosal epithelial dysplasia.
6. Adjust your mentality, establish an optimistic and positive attitude towards life, enhance your confidence and courage to overcome the disease, and cooperate with the doctor's treatment.
7, strengthen physical exercise, enhance physical fitness, improve disease resistance, adhere to appropriate daily exercise for 30 minutes, such as jogging, playing Tai Chi, swimming and so on.
8. Regularly carry out a health checkup every year, and find that the diet is inspected in time when the patient is swallowed.
Complication
Esophageal carcinoid complications Complications Esophageal cancer
The prognosis of esophageal carcinoids is not as good as that of squamous cell carcinoma.
Symptom
Esophageal cancer symptoms Common symptoms Facial flushing, irritability, asthma, edema, swallowing, dry food, chest... Liver metastasis, esophageal lesions
Esophageal carcinoids are more common in men, with an onset age of 26 to 77 years, with an average age of 54 years.
The main symptoms are post-sternal discomfort or sputum pain during swallowing, and severe swallowing obstruction is rare. The clinical feature of esophageal carcinoids different from other esophageal malignancies is that they can be combined with carcinoid syndrome, especially when combined with liver metastasis. Because carcinoid is a tumor that produces small molecular peptides or amine hormones, secreting serotonin, histamine, kinin and other biologically active substances. Patients can have facial cancer, diarrhea, asthma, edema and other carcinoids. In the case of liver metastasis, the serotonin (5-HT3) secreted by it can directly enter the hepatic vein without being inactivated by the action of monoamine oxidase in the liver, causing the 5-HT3 concentration to increase and causing symptoms.
Clinical symptoms: patients with facial flushing, diarrhea, asthma, edema and other carcinoid syndrome manifested by pain during swallowing or post-sternal discomfort.
Examine
Esophageal carcinoid examination
The positive rate of esophageal cancer biopsy is low, and pathological biopsy is mostly reported as poorly differentiated adenocarcinoma or small cell carcinoma.
Esophageal barium meal angiography
Can be expressed as esophageal mucosal destruction, irregular filling defects, soft tissue shadows visible outside the esophagus, may have esophageal stricture, tube wall stiffness, also visible leiomyomas-like changes.
2. Endoscopy
It is the preferred method for diagnosing this disease. It can determine the location, size and depth of invasion of the tumor. The endoscopic tumor has a clear border and multiple edges. It can be located in the upper, middle or lower part of the esophagus.
3. Somatostatin receptor scintigraphy
In recent years, it has been reported that the somatostatin receptor scintigraphy scan is used to diagnose carcinoid cancer, because there is a high affinity site for somatostatin in carcinoid tissues, and 80% to 90% of the somatostatin-like octreotide can be labeled with radioisotope. Localized diagnosis of carcinoid lesions can also show liver and extra-abdominal metastases.
Diagnosis
Diagnosis and diagnosis of esophageal carcinoid
The diagnosis can be confirmed based on the patient's clinical manifestations and esophageal endoscopy and histopathology.
