5.2.2. Main stage:

Polls and physical examination of the patient hold the students why he govo under the supervision of a teacher. To evaluate the accuracy of surveys fasting but also involved other students. In a survey of patients attention of students he calls back to its collection history of the disease, the presence of chronic inflammatory processes at Prospect and precancerous diseases, occupational hazard, smoking.

Esophageal cancer

Predrakovыe disease and risk factors:

1.                  Benign

a) epithelial - adenomas, polyps

b) Nonepithelial - leyomyomы (with smooth muscle)

2.                  Chronic f zofahyt

3.                  Ahalazyya cardia - idiopatchnyy esophageal motility disorder characterized by increased pressure in the lower third against incomplete ro with slablennya Card and tial zhoma and muscles of the lower third of the esophagus. In these patients, the risk of developing R S increases 16-20 times. Medium term development of ro R S from the onset of symptoms is ahalazyy 15-17. Zloyak and sleep at transf rmatsiya mucosa develops dylatyrovann th plot against the ridge at night irritation not a vacuum yovannoy food.

4.                  Sliding hiatal hernia

5.                  Scars from chemical burns of esophagus

6.                  Smoking

7.                  Drinking liquor

8.                  Drinking heavily hot and cold food

9.                  Features food (in residence raw fish, marinated, p at the bosom, cons e rvovani products)

10.              Most mineralization and salinity of drinking water, nature of soil salt

11.              HPV infection, according to some authors, is the main cause of R S in Asia and South Africa. This virus of at myy as the cause of cervical cancer and oropharyngeal cancer. But this virus is not detected in low incidence R S, where a preview and lyuye adenocarcinoma.

12.              Syndrome Plummer-Vynsona characterized by chronic эzof and hytom against deficiency of iron, fibrosis of the esophageal wall, dysfah IE and. Approximately 10% of these patients develop R S. Pathogenesis of cancer while on a hvoryuvanni unclear. It is believed that the basis of its development is Zofia f and g and t that developed on the background of chronic iron deficiency and areas of the esophagus.

TNM Clinical Classification (7 Edition, 200 7)

T x	Not enough data to assess the primary tumor
T 0	The primary tumor is not defined
T is	Preynvazyvnaya carcinoma
T 1	Infiltration of a mucous membrane or submucosa
T 2	Infiltration of muscle membrane
T 3	Infiltration serosa
T 4	Germination of adjacent organs
N x	Not enough data to estimate regionarnogo l / in
N 0	No of regional metastases l / in
N 1	There are of regional metastases in l / in
M's	Not enough data to determine metastases
M 0	No evidence of distant metastases
M 1	There are distant metastases
M1a M1b	For tumors verhnehrudnoho esophagus Basics of metastasis in cervical lymph nodes Other distant metastases
M1a M1b	For tumors srednehrudnoho esophagus Not specified Nerehyonarny lymph nodes and other distant metastases
M1a M1b	For tumors nyzhnehrudnoho esophagus Metastases in celiac lymph nodes Other distant metastases

Clinic:

Violation of the passage of food through the esophagus (originally coarse meal, then liquid) pain behind the breastbone C thin tion hypersalivation esophageal vomiting (ve d time after eating only a small amount of that food eaten) belching, heartburn symptoms of intoxication

Metaz uvannya

1.                  Lee mfohenne - l / sec units is redost etc. + ing as gastric cancer

2.                  Hematogenous - liver, lungs, k and c ki, peritoneum, brain