Humans ; Esophageal Squamous Cell Carcinoma/pathology* ; Esophageal Neoplasms/pathology* ; Carcinoma, Squamous Cell/pathology* ; Precancerous Conditions/pathology* ; Early Diagnosis

Esophageal Neoplasms/diagnosis* ; Esophagus ; Humans ; Hypopharyngeal Neoplasms ; Hypopharynx ; Neoplasms, Multiple Primary

Hypopharyngeal cancer and esophageal cancer often occur synchronously or metachronously. Timely screening, diagnosis and individual treatment are important to improve the prognosis of patients. At present, there is no clinical guideline or consensus in this cross-cutting area in China, and there is a need of consistent diagnosis and treatment recommendation for these patients. Under the sponsorship of the Committee of Esophageal Cancer in China Anti-Cancer Association, the Chinese Working Group on Cooperative Diagnosis and Treatment of Hypopharyngeal and Esophageal Cancer was established by domestic experts in the fields of otolaryngology head and neck surgery, radiation oncology, and gastrointestinal endoscopy. This consensus document on multiple primary cancers (simultaneous or metachronous) of the hypopharynx and esophagus was developed through literature review, collective experience and expert discussions. The goals of the consensus include: (1) raising concern for this cross-cutting field; (2) establishing a preliminary clinical diagnosis and treatment recommendation; (3) preparing for the establishment of future high-level guidelines through standardized clinical practice.
China ; Consensus ; Esophageal Neoplasms ; diagnosis ; therapy ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; therapy ; Neoplasms, Multiple Primary ; diagnosis ; therapy ; Neoplasms, Second Primary ; diagnosis ; therapy ; Prognosis

Barrett's esophagus (BE) is one of the most prominent diseases in Western countries because of its potential to progress to dysplasia or adenocarcinoma. Recently, the American College of Gastroenterology (ACG), American Gastroenterology Association (AGA), and European Society of Gastrointestinal Endoscopy (ESGE) developed clinical guidelines for the diagnosis and management of BE. All three guidelines commonly stressed the necessity of the endoscopic eradication of confirmed, nonnodular low grade dysplasia or high grade dysplasia, as well as the endoscopic elimination of the remaining BE after an endoscopic resection of visible mucosal abnormalities. An endoscopic resection is also considered for the optimal management of esophageal adenocarcinoma confined to the mucosa (T1a), and even in selective cases of submucosal invasion (T1b). As endoscopic therapy becomes the mainstay for the treatment of BE and its complications, the eligibility of pathologic or endoscopic experts and the BE expert center are being set and strengthened. This paper introduces the statements of the ACG, AGA and ESGE guidelines and compares the similarities and differences between them.
Adenocarcinoma ; Barrett Esophagus ; Diagnosis ; Endoscopy, Gastrointestinal ; Esophageal Neoplasms ; Gastroenterology ; Mucous Membrane

Early detection of esophageal cancer can provide a good prognosis and a possibility of achieving a cure through endoscopic treatment. Owing to the high risk of lymph node metastasis, the prognosis of esophageal cancer is poorer than that of gastric cancer. Therefore, detection of esophageal cancer at an early stage by endoscopic examination is important. The esophagus is not simply the area through which the endoscope passes. To avoid missing esophageal lesions, knowledge of the normal mucosal findings is important to detect minute changes in the esophagus. If suspicious lesions are found, endoscopists should describe the location and characteristics of the lesion in detail, and perform accurate biopsy. If a suspicious part is found, chromoendoscopy using Lugol's solution or image-enhanced endoscopy, such as narrow-band imaging, can help in the decision for further examinations. Biopsy should be performed to confirm the lesion.
Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Endoscopes ; Endoscopy ; Esophageal Neoplasms ; Esophagus ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms

Esophageal cancer is an aggressive malignant tumor with a poor prognosis because of its typically advanced stage at diagnosis and treatment-related morbidity and mortality. Of the two major subtypes, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma, ESCC is prevalent in more than 90 percent of esophageal cancer patients in Korea. Both the incidence and mortality of esophageal cancer are declining, and the relative survival rate of patients with esophageal cancer has improved. These epidemiological changes are attributed to increase in the detection rate of esophageal cancer at localized and regional stages before distant spread of the disease. And the most well-known risk factors for esophageal adenocarcinoma are obesity and gastro-esophageal reflux disease. The carcinogenesis of ESCC is associated with chronic irritation caused by smoking, heavy alcohol use, drinking very hot beverages, and a low socioeconomic status. Understanding the risk factors for esophageal cancer can lead to the identification of preventative strategies to reduce the risk of developing esophageal cancer or to improve the long-term prognosis.
Adenocarcinoma ; Beverages ; Carcinogenesis ; Carcinoma, Squamous Cell ; Diagnosis ; Drinking ; Epidemiology ; Esophageal Neoplasms ; Gastroesophageal Reflux ; Humans ; Incidence ; Korea ; Mortality ; Obesity ; Prognosis ; Risk Factors ; Smoke ; Smoking ; Social Class ; Survival Rate

A subepithelial tumor-like esophageal carcinoma is rare. We report a case of an esophageal squamous cell carcinoma with lymph node metastasis presenting as a small subepithelial tumor. A 68-year-old man presented to our hospital complaining of hoarseness since last three months. Endoscopic examination revealed a 1 cm hard and fixed subepithelial tumor with surface erosion in the lower esophagus. A biopsy specimen was obtained using conventional forceps, and histopathological evaluation revealed few atypical squamous epithelial cells. Subsequent EUS demonstrated a homogeneous hypoechoic lesion in the deep mucosal layer. A CT scan of the chest showed a 3 cm mass in the right upper paratracheal area. EUS-guided fine needle biopsy of the lesion led to the diagnosis of squamous cell carcinoma with lymph node metastasis.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Squamous Cell ; Diagnosis ; Endosonography ; Epithelial Cells ; Esophageal Neoplasms ; Esophagus ; Hoarseness ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Surgical Instruments ; Thorax ; Tomography, X-Ray Computed

Barrett's esophagus (BE) is one of the most prominent diseases in Western countries because of its potential to progress to dysplasia or adenocarcinoma. Recently, the American College of Gastroenterology (ACG), American Gastroenterology Association (AGA), and European Society of Gastrointestinal Endoscopy (ESGE) developed clinical guidelines for the diagnosis and management of BE. All three guidelines commonly stressed the necessity of the endoscopic eradication of confirmed, nonnodular low grade dysplasia or high grade dysplasia, as well as the endoscopic elimination of the remaining BE after an endoscopic resection of visible mucosal abnormalities. An endoscopic resection is also considered for the optimal management of esophageal adenocarcinoma confined to the mucosa (T1a), and even in selective cases of submucosal invasion (T1b). As endoscopic therapy becomes the mainstay for the treatment of BE and its complications, the eligibility of pathologic or endoscopic experts and the BE expert center are being set and strengthened. This paper introduces the statements of the ACG, AGA and ESGE guidelines and compares the similarities and differences between them.
Adenocarcinoma ; Barrett Esophagus ; Diagnosis ; Endoscopy, Gastrointestinal ; Esophageal Neoplasms ; Gastroenterology ; Mucous Membrane

To explore the changes of serum microRNA-183 levels in patients with esophageal squamous cell carcinoma (ESCC) and its clinical significance.
 Methods: Fifty-one patients with ESCC and 55 healthy subjects from Department of Cardiothoracic Surgery, Second Xiangya Hospital, Central South Unicersity were selected for this study. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to determine the level of miRNA-183 in serum samples. Chi-square test and correlation analysis were used to investigate the relationship between serum miRNA-183 level and clinical and pathological parameters of ESCC. Diagnostic efficiency of miRNA-183 and combined carcinoembryonic antigen (CEA) examination for ESCC was analyzed by receiver operating characteristic (ROC) curve.
 Results: 1) The levels of miR-183 in the patients with ESCC (4.47±1.54) were elevated compared with that in the healthy subjects (2.03±0.96), with significant difference (t=9.700, P<0.01). 2) The levels of serum miR-183 in ESCC patients were significantly different among patients with different TNM stages (χ2=4.049, P<0.01), which was not affected by gender, age, smoking, drinking, tumor location, tumor diameter, lymph node metastasis, depth of invasion and differentiation (all P>0.05). The levels of miR-183 were not associated with the serum CEA levels (P>0.05). 3) When the ROC curve analysis was used to diagnose ESCC with the optimal cutoff value of 4.502 for miR-183, the sensitivity, the specificity, the area under the curve (AUC) and 95% confidence interval was 78.9%, 76.2%, 0.762 and 0.830-0.922, respectively. When combined detection of serum miR-183 and CEA was used to diagnose ESCC, the sensitivity, specificity, AUC and 95% confidence interval was 82.3%, 92.6%, 0.877 and 0.814-0.935, respectively.
 Conclusion: Serum miRNA-183 levels in ESCC patients may be increased, which can improve the diagnostic efficiency of ESCC when combined with CEA. Serum miRNA-183 levels is related with tumor TNM stage, which contributes to the judgment of tumor progression and efficacy prediction.
Biomarkers, Tumor ; blood ; Carcinoembryonic Antigen ; blood ; Esophageal Neoplasms ; blood ; diagnosis ; Esophageal Squamous Cell Carcinoma ; blood ; diagnosis ; Humans ; MicroRNAs ; blood ; Predictive Value of Tests ; Prognosis

White light imaging (WLI) may not reveal early upper gastrointestinal cancers. Linked color imaging (LCI) produces bright images in the distant view and is performed for the same screening indications as WLI. LCI and blue laser imaging (BLI) provide excellent visibility of gastric cancers in high color contrast with respect to the surrounding tissue. The characteristic purple and green color of metaplasias on LCI and BLI, respectively, serve to increase the contrast while visualizing gastric cancers regardless of a history of Helicobacter pylori eradication. LCI facilitates color-based recognition of early gastric cancers of all morphological types, including flat lesions or those in an H. pylori-negative normal background mucosa as well as the diagnosis of inflamed mucosae including erosions. LCI reveals changes in mucosal color before the appearance of morphological changes in various gastric lesions. BLI is superior to LCI in the detection of early esophageal cancers and abnormal findings of microstructure and microvasculature in close-up views of upper gastrointestinal cancers. Excellent images can also be obtained with transnasal endoscopy. Using a combination of these modalities allows one to obtain images useful for establishing a diagnosis. It is important to observe esophageal cancers (brown) using BLI and gastric cancers (orange) surrounded by intestinal metaplasia (purple) and duodenal cancers (orange) by LCI.
Diagnosis ; Endoscopy ; Esophageal Neoplasms ; Gastrointestinal Neoplasms ; Helicobacter pylori ; Mass Screening* ; Metaplasia ; Microvessels ; Mucous Membrane ; Stomach Neoplasms