Diagnostic techniques in esophageal cancer

Year 2012, Volume: 29 Issue: 4S, 209 - 214, 07.05.2013

Atila Türkyılmaz

https://doi.org/10.5835/jecm.omu.29.s4.004

Abstract

The diagnostic tests for the evaluation of the esophagus are; showing structural distortions, identification of functional abnormalities, and measurement of exposure of esophagus to gastric juice. Plain radiographs have very low diagnostic value in the examination of the esophagus. In evaluation of the morphology and motor function of the esophagus, barium esophagography is the first choice in radiological examination. Computed tomography is used to evaluate the relationship between esophageal cancer and mediastinal structures. Magnetic resonance imaging hasn’t got a specific indication in esophagus diseases. Recently, positron emission tomography’s effectiveness has been identified in esophagus cancer. The main application field of endoscopic ultrasonography in esophageal diseases is staging esophageal cancer. The most common indications for esophagoscopy are noncardiac chest pain, persistent gastroesophageal reflux symptoms, recurrent aspiration pneumonia, dysphagia, odynophagia and esophageal abnormal radiographs.

Keywords

Esophagus, Cancer, Diagnostic techniques

Özofagus kanserinde tanısal teknikler

Abstract

Özofagusun değerlendirilmesi için diagnostik testler; yapısal bozuklukların gösterilmesi, fonksiyonel anomalilerin belirlenmesi ve özofagusun mide suyuna maruziyetinin ölçülmesinden oluşmaktadır. Düz grafilerin özofagus incelemesinde tanı değeri oldukça düşüktür. Özofagusun morfolojisi ve motor fonksiyonlarının değerlendirilmesinde ilk tercih edilen radyolojik tetkik baryumlu özofagografidir. Bilgisayarlı tomografi özofagus kanseri ile mediastinal yapılar arasındaki ilişkiyi değerlendirmede kullanılır. Manyetik rezonans görüntülemenin özofagus hastalıklarında spesifik bir endikasyonu bulunmamaktadır. Son zamanlarda özofagus kanserinde pozitron emisyon tomografinin etkinliği saptanmıştır. Endoskopik ultrasonografinin özofagus hastalıklarında esas uygulama alanı özofagus kanserinin evrelendirilmesidir. Özofagoskopi için en yaygın endikasyonlar; nonkardiyak göğüs ağrısı, ısrar eden gastroözofagial reflü semptomları, tekrarlayan aspirasyon pnömonisi, disfaji, odinofaji ve anormal özofajiyal radyografidir.  

Keywords

Özofagus, Kanser, Tanısal teknikler

References

• Antoch, G., Freudenberg, L.S., Stattaus, J., Jentzen, W., Mueller, S.P., Debatin, J.F., Bockisch, A., 2002. Whole-body positron emission tomog- raphy-CT: Optimized CT using oral and IV contrast materials. A.J.R. 179, 1555-1560.
• Balzarini, L., Potepan, P., Musumeci, R.N., 1998. Diagnosis and staging of esophageal carcinoma by magnetic resonance imaging. In Meyers MA, ed. Neoplasms of the Digestive tract: Imaging, staging, and management. Philadelphia: Lippincott-Raven. 49-59.
• Bektaş, A., 2002. Tanısal işlemler. Özofagoskopi. In Yüksel, M., Başoğlu, A., ed. Özofagus hastalıklarının tıbbi ve cerrahi tedavisi. 47-58.
• Brucher, B.L., Weber, W., Bauer, M., Fink, U., Avril, N., Stein, H.J., Werner, M., Zimmerman, F., Siewert, J.R., Schwaiger, M., 2001. Neoadju- vant therapy of esophageal squamous cell carcinoma: Response evaluation by positron emission tomography. Ann. Oncol. 233, 300-309.
• Buecker, A., Wein, B.B., Neuerburg, J.M., Guenther, R.W., 1997. Esophageal perforation: comparison of use of aqueous and barium-containing contrast media. Radiology. 202, 683-686.
• Canto, M.I.F., 1999. Esophageal cancer screening by chromoendoscopy. Techniques Gastrointest Endosc. Esophagea Neoplasm. 1, 50-52.
• Chandrasoma, P., 1999. Norman Barrett: So close, yet 50 years away from the truth. J. Gastrointest. Surg. 3, 7-14.
• Choi, J.Y., Lee, K.H., Shim, Y.M., Lee, K.S., Kim, J.J., Kim, S.E., Kim, B.T., 2000. Improved detection of individual nodal involvement in squamous cell carcinoma of the esophagus by FDG-PET. J. Nucl. Med. 41, 808-815.
• Dodds, W.J., 1977. Current concepts of esophageal motor function: clinical implications for radiology. A.J.R. Am. J. Roentgenol. 128, 549- 561.
• Drudi, F.M., Trippa, F., Cassone, F., Righi, A., Iascone, C., Ricci, P., David, V., Passariello, R., 2002. Esophagogram and CT vs endoscopic and surgical specimens in the diagnosis of esophageal carcinoma. Radiol. Med. 103, 344-352.
• Eroğlu, A., Türkyılmaz, A., Aydın, Y., 2009. Özofagus hastalıklarında stent uygulamaları. Turkiye klinikleri. J. Thor. Surg-Special. Topics. 2, 95-99.
• Flamen, P., Lerut, A., Van Cutsem, E., De Wever, W., Peeters, M., Stroobants, S., Dupont, P., Bormans, G., Hiele, M., De Leyn, P., Van Raem- donck, D., Coosemans, W., Ectors, N., Haustermans, K., Mortelmans, L., 2000a. Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma. J. Clin. Oncol. 18, 3202-3210.
• Flamen, P., Lerut, A., Van Cutsem, E., Cambier, J.P., Maes, A., De Wever, W., Peeters, M., De Leyn, P., Van Raemdonck, D., Mortelmans, L., 2000b. The utility of positron emission tomography for the diagnosis and staging of recurrent esophageal cancer. J. Thorac. Cardiov. Sur. 120, 1085-1092.
• Flamen, P., Van Cutsem, E., Lerut, A., Cambier, J.P., Haustermans, K., Bormans, G., De Leyn, P., Van Raemdonck, D., De Wever, W., Ectors, N., Maes, A., Mortelmans, L., 2002. Positron emission tomography for assessment of the response to induction radiochemotherapy in locally advanced oesophageal cancer. Ann. Oncol. 13, 361-368.
• Ghahremani, G.G., Weingardt, J.P., Curtin, K.R., Yaghmai, V., 1996. Detection of occult esophageal narrowing with barium tablet during chest radiography. Clin. Imag. 20, 184-190.
• Giovagnoni, A., Valeri, G., Ferrara, C., 2002. MRI of esophageal cancer. Abdom. Imaging. 27, 361-366.
• Gore, R.M., Yaghmai, Y., Ghahremani, G.G., 2005. Radiologic evaluation of the esophagus. In Shields, T.W., LoCicero, J., Ponn, R.B., Rusch, V.W., ed. General thtoracic surgery, vol 2, 6th ed. Philadelphia: Lippincott Williams and Wilkins. 1939-1955.
• Hameeteman, W., Tytgat, G.N.J., Houthoff, H.J., van den Tweel, J.G., 1989. Barrett’s esophagus: Development of dysplasia and adenocarci- noma. Gastroenterology. 96, 1249–1256.
• Himeno, S., Yasuda, S., Shimada, H., Tajima, T., Makuuchi, H., 2002. Evaluation of esophageal cancer by positron emission tomography. Jpn. J. Clin. Oncol. 32, 340-346.
• Kato, H., Kuwano, H., Nakajima, M., Miyazaki, T., Yoshikawa, M., Masuda, N., Fukuchi, M., Manda, R., Tsukada, K., Oriuchi, N., Endo, K., 2002a. Usefulness of positron emission tomography for assessing the response of neoadjuvant chemoradiotherapy in patients with esopha- geal cancer. Am. J. Surg. 184, 279-283.
• Kato, H., Kuwano, H., Nakajima, M., Miyazaki, T., Yoshikawa, M., Ojima, H., Tsukada, K., Oriuchi, N., Inoue, T., Endo, K., 2002b. Compari- son between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma. Cancer. 94, 921-928.
• Kinkel, K., Lu, Y., Both, M., Warren, R.S., Thoeni, R.F., 2002. Detection of hepatic metastases from cancers of the gastrointestinal tract by using noninvasive imaging methods (US, CT, MR imaging, PET): A meta-analysis. Radiology. 224, 748-756.
• Ott, D.J., Kelley, T.F., Chen, M.Y., Gelfand, D.W., 1991. Evaluation of the esophagus with a marshmallow bolus: Clarifying the cause of dys- phagia. Gastrointest. Radiol. 16, 1-4.
• Ökten, İ., 2003. Özofagus kanserleri. In Ökten, İ., Güngör, A. Göğüs cerrahisi, Cilt-II. 1247-1308.
• Riedel, M., Stein, H.J., Mounyam, L., Busch, R., Siewert, J.R., 2000. Predictors of tracheobronchial invasion of suprabifurcal oesophageal cancer. Respiration. 67, 630-637.
• Rosch, T., 1995. Endosonographic staging of esophageal cancer: A review of literature results. Gastrointest. Endosc. Clin. N. Am. 5, 537-547.
• Salo, J.A., Kivilaakso, E.O., Kiviluoto, T.A., Virtanen, I.O., 1996. Cytokeratin profile suggests metaplastic epithelial transformation in Barrett’s oesophagus. Ann. Med. 28: 305-309.
• Sawney, R.A., Shields, H.M., Allan, C.H., Boch, J.A., Trier, J.S., Antonioli, D.A., 1996. Morphological characterization of the squamocolumnar junction of the esophagus in patients with and without Barrett’s epithelium. Dig. Dis. Sci. 41, 1088-1098.
• Sorbi, D., Gostout, C.J., Henry, J., Lindor, K.D., 1999. Unsedated small-caliber esophagogastroduodenoscopy (EGD) versus conventional EGD: A comparative study. Gastroenterology. 117, 1301-1307.
• Stark, P., Thordarson, S., McKinney, M., 1990. Manifestations of esophageal disease on plain chest radiographs. A.J.R. 155, 729-734.
• Tüney, D., 2002. Tanısal işlemler: A) Özofagus radyolojisi. In Yüksel, M., Başoğlu, A., ed. Özofagus hastalıklarının tıbbi ve cerrahi tedavisi. 21-46.
• Türkyılmaz, A., Aydın, Y., Genç, F., Eroğlu, A., 2008. Çocuklarda özefagusa yabancı cisim kaçması sıklığını artıran etken: Alkalen piller. Türk Göğüs Kalp Damar cerrahi. 16, 250-253.
• Turkyilmaz, A., Eroglu, A., Aydin, Y., Tekinbas, C., Muharrem Erol, M., Karaoglanoglu, N., 2009a. The management of esophagogastric anas- tomotic leak after esophagectomy for esophageal carcinoma. Dis. Esophagus. 22, 119-126.
• Türkyılmaz, A., Aydın, Y., Yılmaz, Ö., Aslan, S., Eroğlu, A., Karaoğlanoğlu, N., 2009. Özofagus yabancı cisimleri: 188 olgunun analizi. Ulus. Travma Acil Cer. 15, 222-227.
• Turkyilmaz, A., Eroglu, A., Aydin, Y., Karaoglanoglu, N., 2009b. The relationship of serum CEA and CA 19–9 levels to liver metastasis and pancreatic invasion in esophageal cancer. Turk J. Med. Sci. 39, 895-899.
• Turkyilmaz, A., Aydin, Y., Eroglu, A., Bilen, Y., Karaoglanoglu, N., 2009d. Palliative management of esophagorespiratory fistula in esophageal malignancy. Surg. Laparo. Endo. Per. 19, 364-367.
• Turkyilmaz, A., Eroglu, A., Aydin, Y., Yılmaz, Ö., Karaoglanoglu, N., 2009c. Survival in esophageal cancer patients with hematogenous distant organ metastases. Turk J. Med. Sci. 39, 415-421.
• Wallace, M.B., Nietert, P.J., Earle, C., Krasna, M.J., Hawes, R.H., Hoffman, B.J., Reed, C.E., 2002. An analysis of multiple staging management strategies for carcinoma of the esophagus: Computed tomography, endoscopic ultrasound, positron emission tomography, and thoracoscopy/ laparoscopy. Ann. Thorac. Surg. 74, 1026-1032.
• Wu, L.F., Wang, B.Z., Feng, J.L., Cheng, W.R., Liu, G.R., Xu, X.H., Zheng, Z.C., 2003. Preoperative TN staging of esophageal cancer. Com- parison of miniprobe ultrasonography, spiral CT and MRI. World J. Gastroentero. 9, 219-224.
• Vanagunas, A.D., Srivastava, A., 2005. Endoscopy of the esophagus. In Shields, T.W., LoCicero, J., Ponn, R.B., Rusch, V.W. General thoracic surgery, vol 2, 6th ed. Philadelphia: Lippincott Williams and Wilkins. 1956-1968.
• Yokoyama, A., Ohmori, T., Makuuchi, H., Maruyama, K., Okuyama, K., Takahashi, H., Yokoyama, T., Yoshino, K., Hayashida, M., Ishii, H., 1995. Successful screening for early esophageal cancer in alcoholics using endoscopy and mucosa iodine staining. Cancer. 76, 928-934.
• Zhuang, Z., Vortmeyer, A.O., Mark, E.J., Odze, R., Emmert-Buck, M.R., Merino, M.J., Moon, H., Liotta, L.A., Duray, P.H., 1996. Barrett’s esophagus: Metaplastic cells with loss of heterozygosity at the APC gene locus are clonal precursors to invasive adenocarcinoma. Cancer Res. 56, 1961-1964.
• Zuccaro, G.Jr., Rice, T.W., Goldblum, J., Medendorp, S.V., Becker, M., Pimentel, R., Gitlin, L., Adelstein, D.J., 1999. Endoscopic ultrasound cannot determine suitability for esophagectomy after aggressive chemoradiotherapy for esophageal cancer. Am. J. Gastroenterol. 94, 906- 912.