食管癌:了解这种罕见且常被误诊的高分化食管鳞状细胞癌。

IF 3 4区 医学 Q1 Medicine Translational gastroenterology and hepatology Pub Date : 2023-01-01 DOI:10.21037/tgh-22-37
Ikponmwosa Enofe, Harish Venkataraj, Paul Hong, Xianzhong Ding, Abdul Haseeb
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摘要

背景与目的:网状食管癌是一种罕见的高分化鳞状细胞癌。与其他形式的食管癌不同,食道CC很难通过内窥镜活检诊断。这可能导致诊断延误并增加发病率。我们回顾了现有的文献来阐明该病的发病机制、诊断、治疗和预后。我们的目标是更好地了解这种罕见的疾病,并有助于及时诊断,以减少相关的发病率和死亡率。方法:广泛查阅PubMed、Embase、Scopus、Google Scholar等文献。我们检索了从食道CC开始至今发表的文献。我们报告流行病学趋势、临床表现、诊断和治疗策略,以正确识别病例,以减少漏诊的可能性。主要内容和发现:食管CC的相关危险因素是慢性反流性食管炎、吸烟、饮酒、免疫抑制和贲门失弛缓症。吞咽困难是最常见的表现。主要诊断方式是食管胃十二指肠镜检查(EGD),但诊断很容易被遗漏。为了便于早期诊断,Chen等人提出了一种组织学评分系统,作者根据对cc患者进行的大量粘膜活检,描述了一些常见的组织学特征。结论:早期诊断需要对该疾病进行高度的临床怀疑,并进行密切的内镜随访和重复活检。手术仍然是治疗的金标准,如果患者得到早期诊断,手术与良好的预后有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Esophageal carcinoma cuniculatum: a narrative review to understand this rare and commonly misdiagnosed variant of well-differentiated esophageal squamous cell carcinoma.

Background and objective: Esophageal carcinoma cuniculatum (CC) is a rare variant of a well-differentiated squamous cell carcinoma (SCC). Unlike other forms of esophageal cancers, CC of the esophagus is difficult to diagnose on endoscopic biopsies. This can lead to a delay in the diagnosis and increases morbidity. We reviewed the available literature to shed light on the etiopathogenesis, diagnosis, treatment, and outcomes of this disease. Our aim is to create a better understanding of this rare disease entity and contribute to a timely diagnosis to reduce the associated morbidity and mortality.

Methods: Extensive review of PubMed, Embase, Scopus, Google Scholar was conducted. We identified the published literature on Esophageal CC from inception till date. We report epidemiological trends, clinical presentation, diagnostic and treatment strategies to correctly identify the cases to reduce the likelihood of a missed diagnosis of esophageal CC.

Key content and findings: Associated risk factors for esophageal CC are chronic reflux esophagitis, smoking, alcohol consumption, immunosuppression, and achalasia. Dysphagia is the most common presentation. Primary diagnostic modality is an esophagogastroduodenoscopy (EGD), but diagnosis can be easily missed. To favor an early diagnosis, a histological scoring system has been proposed by Chen et al. where authors describe specific histological features that appear to be common based on the numerous mucosal biopsies examined from patients with CC.

Conclusions: A high clinical suspicion for the disease along with close endoscopic follow-up with repeat biopsies is needed for an early diagnosis. Surgery remains the gold standard for treatment and is associated with a favorable prognosis when the patients are diagnosed early.

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来源期刊
CiteScore
8.20
自引率
0.00%
发文量
1
期刊介绍: Translational Gastroenterology and Hepatology (Transl Gastroenterol Hepatol; TGH; Online ISSN 2415-1289) is an open-access, peer-reviewed online journal that focuses on cutting-edge findings in the field of translational research in gastroenterology and hepatology and provides current and practical information on diagnosis, prevention and clinical investigations of gastrointestinal, pancreas, gallbladder and hepatic diseases. Specific areas of interest include, but not limited to, multimodality therapy, biomarkers, imaging, biology, pathology, and technical advances related to gastrointestinal and hepatic diseases. Contributions pertinent to gastroenterology and hepatology are also included from related fields such as nutrition, surgery, public health, human genetics, basic sciences, education, sociology, and nursing.
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