Esophageal stromal tumor
Introduction
Introduction to esophageal stromal tumor Esophageal stromal tumors are another type of mesenchymal tumors that originate in the esophagus in addition to leiomyoma or neurogenic tumors, and their origins are still unrecognized. It is believed that esophageal stromal tumors originate from primitive pluripotent stem cells and have multi-directional differentiation potential, but most authors believe that the tumor originates from Caial cells in stromal cells that regulate visceral motor function. basic knowledge The proportion of illness: 0.005%-0.008% Susceptible people: no specific population Mode of infection: non-infectious Complications: esophageal cancer
Cause
Esophageal stromal tumor etiology
Environmental factors (40%):
Environmental factors are an important factor in the generation of esophageal stromal tumors. The etiology of esophageal stromal tumors is closely related to the eating habits of various places. Frequent consumption of mildew, pickled, smoked and other foods, or excessive intake of salt, may increase the risk of esophageal stromal tumors. Smoked fish contain more 3,4-benzopyrene, moldy foods contain many mycotoxins, and pickled foods contain nitrous acid, which are carcinogenic. Therefore, everyone must develop good habits, refuse junk food, and eat more fruits and vegetables.
Genetic factors (20%):
Studies have shown that the etiology of esophageal stromal tumors is also related to heredity. The incidence of esophageal stromal tumors in patients' families is higher than that of the average person. These people may be due to the similar living environment and eating habits, which increases the incidence of esophageal stromal tumors. Opportunity, which also indicates that genetic factors play an important role in the pathogenesis of esophageal stromal tumors.
Prevention
Esophageal stromal tumor prevention
Strengthen physical exercise, enhance physical fitness, and exercise more in the sun. Excessive sweating can excrete acidic substances in the body with sweat, avoiding the formation of acidic body.
Have a good attitude to cope with stress, work and rest, do not fatigue. Visible pressure is an important cause of cancer. Chinese medicine believes that stress leads to excessive physical weakness, which leads to decreased immune function, endocrine disorders, metabolic disorders in the body, leading to the deposition of acidic substances in the body. Stress can also lead to mental stress causing qi stagnation and blood stasis. Invagination and so on.
Don't eat too much salty and spicy food, don't eat food that is overheated, too cold, expired and deteriorated; those who are frail or have certain genetic genes should eat some cancer-preventing foods and alkaline substances with high alkalinity as appropriate. Food, maintain a good mental state to develop good habits, stop smoking and limit alcohol. Smoking, the World Health Organization predicts that if people no longer smoke, after five years, the world's cancer will be reduced by 1/3; secondly, no alcohol. Smoke and alcohol are extremely acidic and acidic substances. People who smoke and drink for a long time can easily lead to acidic body. Finding timely treatment of the disease is key.
Complication
Esophageal stromal tumor complications Complications Esophageal cancer
Concurrent with esophageal cancer and other diseases.
Symptom
Esophageal stromal tumor symptoms Common symptoms Swallowing sore dysphagia Dysphagia
Clinical manifestation
In addition to some similar biological and morphological features of gastrointestinal stromal tumors (GIST), esophageal stromal tumors have their own independent characteristics:
1. The incidence rate is low, accounting for about 25% of esophageal mesenchymal tumors in the same period.
2, mostly benign, biological behavior is better than stromal tumors occurring in the gastrointestinal tract.
3, the tumor volume is small, due to early dysphagia difficulties and timely treatment.
4, smooth muscle metaplasia rate is high.
5, lack of neural differentiation, S-100 are negatively expressed, histologically no silk-like fibers.
6. GIST expression CD117 and CD34 are usually negative, only a few parts can be focally positive, and the positive rate of CD34 in esophageal stromal tumors is 85.7%.
The disease mainly needs to be differentiated from esophageal leiomyoma. Immunohistochemistry is currently the most effective means for diagnosing esophageal stromal tumors.
Examine
Esophageal stromal tumor examination
CT, endoscopic ultrasonography, and gastrointestinal angiography can assist in the determination of GISTs size, local infiltration, metastasis, and location.
Diagnosis
Diagnosis and diagnosis of esophageal stromal tumor
Medical examination
Some patients with larger tumors can reach the abdominal mass, smooth surface, nodules or lobulation.
Laboratory inspection
Patients may have anemia, hypoproteinemia, and fecal occult blood positive.
Gastroscope and ultrasound gastroscopy
For gastric GIST, gastroscopy can help to identify the location and size of the tumor. Endoscopic ultrasonography can assist in the diagnosis of extrahepatic tumors, and the location, size, origin, local infiltration, and metastasis of GIST. Some patients have a pathological diagnosis.
CT examination
CT scan revealed that the tumors were mostly round or round, and a few were irregular. Benign tumors are less than 5cm in size, uniform in density, sharp in edge, rarely invade adjacent organs, and may have calcification. Malignant tumors are more than 6cm, the boundary is unclear, and it is afflicted with adjacent organs. It can be lobulated, density is uneven, and the center is prone to necrosis, cystic changes and hemorrhage. Tumors can be mixed with high and low density, and calcification is rare. Enhanced CT showed uniform uniform density and more uniform moderate or significant enhancement, spiral CT showed obvious in the venous phase. This kind of strengthening is more common in low-grade malignant gastrointestinal stromal tumors. Necrosis and cystic changes often show obvious enhancement around the tumor. CT digestive tract three-dimensional reconstruction for swollen
18FDG-PET and 18FDG-PET/CT
CT, MRI and other imaging methods only evaluate the size of the tumor, the density of the tumor and the distribution of blood vessels in the tumor, and can not reflect the metabolism of the tumor. PET examination with 18-fluorodeoxyglucose can make up for the above physics examination, its principle Is a gastrointestinal stromal tumor is a highly metabolized tumor, using a strong glycolytic reaction in the tumor to ingest high-density 18-fluorodeoxyglucose tracking development, sensitive to early metastasis or recurrence than CT, and in evaluating tumor versus chemotherapy The reaction of the drug is obviously superior to other physical examination methods. The PET and CT combined scanning method can simultaneously evaluate the anatomy and metabolism of the tumor, and the evaluation of tumor staging and treatment effect is better than CT, and it also targets other solid tumor molecules. The judgment of the therapeutic effect provides a reference.
Other auxiliary inspection
The X-ray meal shows that the edges are neat and round, and the center may have a "umbilical" ulcer, or it may be compressed or displaced. The superior mesenteric artery DSA is of great significance for the diagnosis and tumor localization of small intestine GIST.
