食道癌 

食道癌
Esophageal cancer
同义词Oesophageal cancer
轉移到肝臟的末期食道癌腫瘤
症状吞嚥障礙不明原因體重減輕嘶啞锁骨周圍的淋巴結腫大[1]
类型食道鱗狀細胞癌、食道腺癌[2]
风险因子吸菸喝酒、喝非常燙的東西、嚼槟榔肥胖症胃食道逆流[3][4]
診斷方法活體組織切片[5]
治療手術化学疗法放射線療法[5]
预后五年存活率 ~15%[1][6]
盛行率截至 2015 年共有746,000人[7]
死亡數439,000 (2015)[8]
分类和外部资源
醫學專科肿瘤学普通外科(一般外科)
ICD-112B70
ICD-9-CM150.4、​150.3、​150.2、​150.5、​150.8
OMIM133239
DiseasesDB9150
MedlinePlus000283
eMedicine277930、​368206
食道癌
被切除的鱗狀食道癌腫瘤樣本
类型esophageal neoplasm[*]食道疾病[*]胃腸癌疾病
診斷方法內視鏡X射线计算机断层成像正子斷層照影活體組織切片
分类和外部资源
醫學專科肿瘤学、​普通外科、​胃肠学
ICD-112B70
ICD-9-CM150.4、​150.3、​150.2、​150.5、​150.8
OMIM133239
DiseasesDB9150
MedlinePlus000283
eMedicine277930、​368206

食道癌(esophageal cancer)指發生在食道癌症[9]。常見的症狀包括吞嚥困難與體重減輕[10],其他症狀還有吞嚥疼痛沙啞鎖骨週邊淋巴結腫大、乾咳、以及咳血吐血[10]

有兩大類食道癌較為常見:鱗狀細胞癌主要盛行於開發中國家;而腺癌則在已開發國家較為常見[9][2],其他的類型則比較少有[9]。鱗狀細胞癌主要因為吸菸、飲酒、熱飲、嚼檳榔[4][3]、以及飲食習慣不佳引起[11];腺癌則主要由吸菸肥胖、和胃食道逆流所引起[11]。在腺癌發生前,經常可以先看到巴雷斯特食道症[9]。鱗狀細胞癌主要來自食道內沿的皮膚細胞[12],而腺癌則來自食道下三分之一段上皮組織中的腺體細胞[9][13]

食道癌的診斷需使用內視鏡切片檢查[5][14]。預防食道癌的方式則包括戒菸與健康飲食[9][10]。食道癌的治療依分期、位置、病人整體身心狀況、以及日常生活功能而定[14]。小而未擴散的鱗狀上皮癌常可藉手術治癒[14],但大多數的狀況都需要在手術外搭配化學療法放射療法[14],化學療法與放射療法可減緩體積較大的腫瘤生長速度[2]。已經轉移的食道癌或是身體狀況不適合手術的患者則建議接受安寧緩和醫療[14]。治療的成效受疾病本身的狀況與病人的其他疾病影響,但由於食道癌大多在晚期才被診斷[9][15],因此普遍預後不佳[16]五年存活率平均為13%-18%[1][6])。

食道癌在2012年的全球癌症發生率中排行第八(45.6萬個新診斷患者)[9],平均每年造成40萬人死亡(死亡數正在上升中:在1990年時只造成34.5萬人死亡)[9][17],食道癌的發生率在各國間有巨大差異,全球有一半病患都集中在中國[9]。食道癌好發於男性,相對於女性而言,男性的得病風險大約是三倍[9]

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  2. ^ 2.0 2.1 2.2 Montgomery, EA; et al. Oesophageal Cancer. Stewart, BW; Wild, CP (编). World Cancer Report 2014. World Health Organization. 2014: 528–543. ISBN 9283204298. 
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  4. ^ 4.0 4.1 Akhtar, S. Areca nut chewing and esophageal squamous-cell carcinoma risk in Asians: a meta-analysis of case-control studies. Cancer Causes & Control. February 2013, 24 (2): 257–65. PMID 23224324. doi:10.1007/s10552-012-0113-9. 
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  6. ^ 6.0 6.1 SEER Stat Fact Sheets: Esophageal Cancer. National Cancer Institute. [2014-06-18]. (原始内容存档于2014-07-06). 
  7. ^ GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.. Lancet. 2016-10-08, 388 (10053): 1545–1602. PMC 5055577可免费查阅. PMID 27733282. doi:10.1016/S0140-6736(16)31678-6. 
  8. ^ GBD 2015 Mortality and Causes of Death, Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015.. Lancet. 2016-10-08, 388 (10053): 1459–1544. PMC 5388903可免费查阅. PMID 27733281. doi:10.1016/s0140-6736(16)31012-1. 
  9. ^ 9.00 9.01 9.02 9.03 9.04 9.05 9.06 9.07 9.08 9.09 9.10 World Health Organization. 5.3. World Cancer Report 2014. 2014. ISBN 9283204298. 
  10. ^ 10.0 10.1 10.2 Ferri, Fred. Ferrisri's Clinical Advisor 2013 5 books in 1 1st ed. Elsevier Mosby. 2012: 389–391. ISBN 9780323083737. 
  11. ^ 11.0 11.1 Zhang, HZ; Jin, GF; Shen, HB. Epidemiologic differences in esophageal cancer between Asian and Western populations.. Chinese journal of cancer. 2012-06, 31 (6): 281–6 [2014-11-28]. PMID 22507220. (原始内容存档于2021-03-08). 
  12. ^ Kelsen, David. Gastrointestinal oncology : principles and practices 2nd ed. Philadelphia, Pa.: Lippincott Williams & Wilkins. 2007: 4 [2014-11-28]. ISBN 9780781776172. (原始内容存档于2014-10-27) (英语). 
  13. ^ Whittemore. David Schottenfeld, Joseph F. Fraumeni, Jr., associate editors, Graham A. Colditz, Jonathan M. Samet, Alice S. , 编. Cancer epidemiology and prevention 3rd ed. Oxford: Oxford University Press. 2006: 697 [2014-11-28]. ISBN 9780199747979. (原始内容存档于2014-10-27) (英语). 
  14. ^ 14.0 14.1 14.2 14.3 14.4 Stahl, M; Mariette, C; Haustermans, K; Cervantes, A; Arnold, D; ESMO Guidelines Working, Group. Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO. Oct 2013, 24 (Suppl 6): vi51–6. PMID 24078662. 
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