Pathological types of mid- to late-stage esophageal cancer

The long-term effects of various carcinogenic factors on the esophageal mucosal epithelium can cause esophageal mucosal inflammation and epithelial hyperplasia, from simple hyperplasia to atypical hyperplasia, and finally canceration, and from cancer to invasive cancer, which takes about ten years. The most common site of esophageal cancer is the middle segment, accounting for about 50%; the lower segment is second, accounting for about 30%; and the upper segment is the least, accounting for about 20%.

The pathological morphology of advanced esophageal cancer is divided into the following 5 types

1. Medullary carcinoma is a ramp-like bulge that invades all layers of the esophageal wall or surrounding tissues. The cut surface is grayish white like brain marrow and may be accompanied by ulcers. This type is more common and has the highest degree of malignancy. It often has obvious external invasion, a low surgical resection rate, a poor prognosis for surgical treatment, a moderate effect of radiotherapy, and a high recurrence rate.

2. Fungus-shaped cancer tumors are round or oval, growing into the lumen, with the edges everted like a mushroom cap. They do not invade the outside obviously, so they have a higher resection rate. They are sensitive to radiotherapy and have good radiotherapy effects.

3. Ulcerative type The ulcerative type is mainly characterized by deeper ulcers with slightly raised edges, which usually do not cause esophageal obstruction. Ulcerative type esophageal cancer often has obvious but localized external invasion and a moderate resection rate. Due to the risk of perforation, this type of esophageal cancer should be treated with close attention during radiotherapy.

4. Stenosis-type cancer grows in a ring shape, is hard, involves the entire circumference of the esophagus, and can easily cause esophageal obstruction. The lesion is generally about 3 cm in length and rarely exceeds 5 cm. This type is less common.

5. Intracavitary tumors are round or oval in shape and protrude into the cavity. They often have a wide base connected to the esophageal wall. The surface of the tumor has erosion or irregular small ulcers. Although intracavitary esophageal cancer is often large in size, it often has no obvious external invasion. Therefore, the surgical resection rate is very high and radiotherapy is also very sensitive. However, the long-term results of both surgery and radiotherapy are unsatisfactory. In addition, there are a few cases whose pathological morphology cannot be classified, which is called unclassified.