Classification of advanced esophageal cancer

Since patients with advanced esophageal cancer all have clinical symptoms, the classification of advanced esophageal cancer is different from that of early esophageal cancer. Analysis of a large number of pathological materials shows that the medullary type is the most common, accounting for 56.7% to 58.5%; the mushroom type is second, accounting for 17% to 18.4%; the ulcer type is next, accounting for 11% to 13.2%; the stricture type (8.5% to 9.5%) and the intracavitary type (2.9% to 5%) are less common.

1. Medullary type

The tumor has invaded the entire layer of the esophageal wall, causing the wall to thicken significantly, involving most or all of the circumference of the esophagus. The upper and lower edges of the cancer are bulging like slopes, and there are often ulcers of varying depths on the surface. The tumor cross-section is grayish white, like brain marrow. This type is common and highly malignant.

2. Mushroom type

The tumor is oval and mushroom-shaped, protruding into the esophageal cavity, with a clear boundary between the raised edge and the surrounding esophageal mucosa. There are often shallow ulcers on the surface of the tumor, with an uneven bottom, often covered with a layer of brown inflammatory exudate.

3. Ulcerative type

There are deep ulcers on the surface of the tumor, with varying shapes and sizes. The ulcers generally penetrate deep into the muscle layer, and some even invade the fibrous tissue around the esophagus.

4. Narrowing type

The tumor forms a distinct annular stenosis, involving the entire circumference of the esophagus, with unclear boundaries between the tumor and normal tissue, and a length of no more than 5 cm. The surface is eroded, and the proximal esophageal cavity is significantly dilated. In addition, a few esophageal cancer specimens are polyp-like and protrude into the esophageal cavity, so some authors believe that this is another type of esophageal cancer - the intracavitary type.