A 70-year-old patient with chronic gastritis was diagnosed with early esophageal cancer during a physical examination. This diagnosis played a key role.

For tumor diseases, we have always emphasized early detection and early treatment, and the key point is to detect potential abnormal symptoms in time, and to conduct targeted examinations to find the lesion area. However, early tumors may have no symptoms. For example, early dysplasia of esophageal cancer may not cause burning or chest pain. How should it be discovered? In April this year, our hospital treated a patient with early esophageal cancer. She is a typical example of early asymptomatic manifestations. So how did the patient discover the lesion?

Case sharing:
The patient, Ms. Sun, was 70 years old and female. She had been suffering from chronic gastritis for many years and had a regular physical examination every year. In April 2020, she went to the hospital for a gastroscopy and found something abnormal.
Medical history: chronic gastritis for many years, with continuous regular treatment.
Physical examination: body temperature 36°5 normal, pulse 83 times/minute, respiration 16 times/minute, blood pressure 128/80mmHg. The abdomen is flat, respiratory movement is normal, there is no umbilical hernia, abdominal wall varicose veins, no rash, pigmentation, no gastrointestinal type and peristaltic waves. The abdominal wall is soft, without tenderness, rebound pain, muscle tension, no mass, liver and spleen are not palpable. There is no tenderness in the gallbladder area, and Murphy's sign is negative. The kidneys are not palpable, there is no tenderness in the kidney area and ureter point, and the water sound is negative. The liver dullness boundary is normal, there is no percussion pain in the liver and kidney areas, and the shifting dullness is negative. Bowel sounds are normal, and no vascular murmurs are heard.

Symptom examination: Gastroscopy revealed that the posterior wall of the esophagus was slightly edematous at 16-20 cm from the esophagus, with a little white fur on the surface. NBI: The mucosa was brown, iodine staining: 16-20 cm, the mucosa at 5-8 o'clock was not colored.
Pathological diagnosis: esophageal squamous epithelial hyperplasia, local hyperplasia is atypical. Since the patient usually has no dysphagia, no pain behind the sternum, no abnormal symptoms such as weight loss and fatigue, a deep examination was performed. When the esophageal lesion was magnified, no obvious IPCL was found, and no other obvious thickened and tortuous blood vessels were found. A biopsy of the upper esophageal tissue showed high-grade squamous epithelial dysplasia, so the diagnosis was early esophageal cancer.
Treatment plan <br/>The results of gastroscopy and pathological examination showed that the patient was in the dysplastic stage, which is what we often call the early stage of cancer. The lesion area is still infiltrating and spreading, and is in a state of chronic disease development. The patient has no obvious symptoms. At this time, the lesion area is removed in time under gastroscopy, and the patient is allowed to stay in the hospital for relevant drug treatment, and the postoperative condition is observed. The patient is currently in good condition with no adverse reactions.

How to detect early esophageal cancer in the golden period <br/>Early diagnosis and treatment is recognized as the golden period for the treatment of esophageal cancer and other tumor diseases. The patient Ms. Sun in the above case was lucky to discover the lesion and took regular treatment. The question we want to discuss is how to detect early cancer when there are no symptoms.
Early symptoms of esophageal cancer include difficulty swallowing, pain behind the sternum, choking in the esophagus, tingling or pulling sensation during eating, etc. If such symptoms occur, you should go to the hospital for examination in time.
How to detect early esophageal cancer without symptoms: If there are no obvious symptoms like the patient in the case, it is easy to delay the disease at this time. But we can find two key points from the specific situation. One is that the patient has had chronic gastritis for many years, and the other is that the patient has a good habit of regular physical examinations. Based on these two factors, we can draw a conclusion that people with chronic diseases belong to the high-risk group for tumor diseases, and regular examinations are conducive to the control of the disease and the screening of memory tumors. Therefore, people with chronic digestive system diseases, including esophagitis and gastrointestinal inflammation, need to be reviewed regularly; and healthy people with digestive system abnormalities should also be checked in time to determine whether it is an acute or chronic disease, or a tendency to cancer.

Key items for diagnosing early esophageal cancer <br/>From the above cases, we can clearly see that gastroscopy plays a vital role in the diagnosis and treatment of early esophageal cancer. Whether there are obvious symptoms or no symptoms, the digestive system organs are inside the body. Simply relying on physical examination, blood test, and tumor cell detection cannot accurately determine the condition; moreover, early dysplasia and tumor properties require pathological testing. If you cannot enter the organs, you cannot collect pathological samples.
Moreover, for early dysplasia and smaller tumors and polyps, endoscopic resection is more convenient and quicker. It is a minimally invasive surgery that causes less trauma to the patient and relatively less stimulation to the lesion, which is beneficial to the patient's recovery. Therefore, we hope that everyone will pay attention to gastroscopy. Those with chronic diseases should have regular physical examinations. Healthy people can also add gastroscopy to their physical examinations. If you often experience digestive system discomfort, you need to have a gastroscopy as soon as possible.