Layke John C, Lopez Peter P
Department of General Surgery, University of Illinois Metropolitan Group Hospitals, Chicago, Illinois 60657, USA.
Am Fam Physician. 2006 Jun 15;73(12):2187-94.
Although significant advancements have been made in the treatment of esophageal cancer, this aggressive malignancy commonly presents as locally advanced disease with a poor prognosis. Despite improvements in the detection of premalignant pathology, newer preventative strategies, and the development of more effective combination therapies, the overall incidence of esophageal carcinomas has risen. A clear association has been established between the development of esophageal cancer and Helicobacter pylori infection, gastroesophageal reflux disease, smoking, and heavy alcohol use. However, the growing number of newly diagnosed esophageal adenocarcinomas, despite widespread treatments with proton pump inhibitors and the eradication of H. pylori, leaves the medical community searching for more answers. There is a potential link between esophageal adenocarcinoma and obesity. Common presenting symptoms of esophageal cancer are dysphagia, odynophagia, and progressive weight loss. The initial assessment for patients with these symptoms is made with double-contrast barium esophagraphy. Treatment modalities include surgery, chemotherapy, radiation therapy, or a combination of modalities. Prevention strategies include smoking and alcohol cessation.
尽管食管癌的治疗已取得显著进展，但这种侵袭性恶性肿瘤通常表现为局部晚期疾病，预后较差。尽管在癌前病变的检测、新的预防策略以及更有效的联合治疗方法的开发方面有所改进，但食管癌的总体发病率仍在上升。食管癌的发生与幽门螺杆菌感染、胃食管反流病、吸烟和大量饮酒之间已建立了明确的关联。然而，尽管广泛使用质子泵抑制剂治疗并根除幽门螺杆菌，但新诊断的食管腺癌数量仍在增加，这使得医学界寻求更多答案。食管腺癌与肥胖之间可能存在联系。食管癌的常见症状为吞咽困难、吞咽疼痛和进行性体重减轻。对有这些症状的患者进行的初步评估采用双重对比钡剂食管造影。治疗方式包括手术、化疗、放疗或多种方式联合使用。预防策略包括戒烟和戒酒。
