推荐回答(2个)
食管癌发生转移一般都是在食管癌晚期出现的症状,食管癌的转移方式一般分为三种:一般性转移,血性转移和骨转移。下面就让
我们分别来了解一下相关的内容介绍。
下面我们来看一下淋巴结转移:食管的淋巴道转移较常见,约占病例的2/3,产生一般较早,首要见于食管旁淋巴结、肺门淋巴结、锁骨上淋巴结及贲门淋巴结,转移以低分化鳞癌及未分化癌多见,转移部位与食管淋巴引流方向有关,上段食道癌可侵犯食管旁、喉后、颈深和锁骨上淋巴结,如出现声嘶,多由于转移淋巴结压迫喉返神经。中段食道癌常产生食管旁或肺门淋巴结转移,也可向上或向下转移。
专家说,食道癌骨转移,这是晚期可能发生远处转移扩撒的部位之一,其发生率随之生存期的延长而加大。食道癌晚期骨转移本身或许不是晚期患者死亡的原因,但其引发的并发症却很致命。食道癌骨转移会引起患者多处骨痛、病理性骨折等临床表现,这是导致食道癌晚期患者生存质量大大降低的主要原因之一。目前,临床上食道癌骨转移的治疗多采用姑息性治疗,主要是西医放疗和药物治疗。食道癌骨转移放疗的目的主要在于缓解骨疼痛症状、减少病理性骨折的危险,其方式包括外照射与放射性核素治疗两类。
血行转移:食道癌的血行转移多发生于食道癌晚期,且较少见。多以肝脏和肺为主,其次为骨、肾、肾上腺及胸膜等。淋巴道转移:是食道癌常见的转移方式,转移部位与食道淋巴的引流方向有关。上段癌可累及食道旁、喉后、颈深和锁骨上淋巴结;中断癌常转移至食道旁或肺门淋巴结,亦可向下或向上转移;而下段癌则多侵犯心包及腹腔淋巴结,偶尔亦可见下段癌转移至上纵隔或锁骨上淋巴结。专家最后说,一般认为食道癌的淋巴道转移,以食道低分化鳞癌或未分化癌多见。
北京武警二院专家介绍食道癌转移的途径: 1.食管壁内扩散:最早出现于食管黏膜层或黏膜下层,因食管黏膜及黏膜下层存在丰富的淋巴管,癌肿可沿食管固有膜或黏膜下层得淋巴管浸润,表面呈苍白或小结节形成。大多数黏膜下扩散在肉眼无明显异常,只有镜检才能证实。沿淋巴扩散的结节酷似第二个原发癌,这种食管壁内的扩散方式有时可距离原发灶5~6cm,因此手术切除的长度适当与否很重要。
2.直接浸润邻近器官:食管上段癌可侵入喉部、气管及颈部软组织,甚至侵入支气管,形成支气管--食管瘘;也可侵入胸导管、奇静脉、肺门及肺组织,部分可侵入主动脉而形成食管-主动脉瘘,引起大出血;下段食管癌常可累及贲门及心包。
3.淋巴转移:这种转移方式比较常见,约占病例的2/3。中段食管癌常转移至食管旁或肺门淋巴结,也可转移至颈部、贲门周围及胃左动脉旁淋巴结;下段食管癌常可转移至食管旁、贲门旁、胃左动脉旁及腹腔等淋巴结,偶尔可至上纵隔及颈部淋巴结。淋巴转移部位依次为给隔、腹部、气管及气管旁、肺门及支气管旁。
4.血行转移:多见于晚期患者,最常见转移至肝(约占1/4)与肺(约占1/5),其它脏器依次为骨、肾、肾上腺、胸膜、网膜、胰腺、心、肺、甲状腺和脑等。
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