Early diagnostic criteria for esophageal cancer

The diagnosis of early esophageal cancer must be determined based on a comprehensive analysis of the patient's symptoms, X-ray barium meal imaging, esophageal cytology, and esophageal endoscopy; mid- and late-stage esophageal cancer can mostly be diagnosed based on clinical manifestations and X-ray barium meal imaging, and esophageal endoscopy plus biopsy can further confirm the diagnosis.

The differential diagnosis includes the following disorders:

l. Reflux esophagitis has symptoms similar to those of early esophageal cancer, such as stabbing pain and burning pain behind the sternum. X-ray examinations often show no obvious abnormalities, but fiberoptic esophagoscopy and cytology examinations can be performed if necessary.

2. Achalasia is more common in young patients with a long medical history and symptoms that vary in severity. X-rays show no contraction or peristalsis of the esophageal body, smooth esophageal mucosa, and "bird-beak-like" narrowing of the cardia. Esophagoscopy can confirm the diagnosis.

3. Benign esophageal stricture Benign esophageal stricture is mostly a sequela of chemical burns, or it may be scar stricture caused by esophagitis. The disease period is generally long, and there is a history of swallowing strong acid or alkali by mistake.

4. Esophageal varices have other signs of liver cirrhosis and portal hypertension, and are more common at the lower end of the esophagus. Extensive cases may involve the thoracic esophagus. X-rays show thickened, tortuous, beaded defects in the mucosal folds, and uneven edges of the esophagus.

5. Periesophageal organ lesions such as mediastinal tumors, periesophageal lymphadenopathy, significantly enlarged left atrium, aortic aneurysm, etc. can all cause varying degrees of external pressure stenosis of the esophagus, resulting in difficulty in swallowing. Esophageal barium meal is helpful for diagnosis.