Author/Dr. Gao Qilong, Director of the First Ward of the Department of Integrated Traditional Chinese and Western Medicine Oncology, Henan Cancer Hospital

Do you know that the phrase

"Drink more hot water" sometimes turns out to be my reminder?

Do you know that

"Eat while the food is hot"

is also a great weapon to hurt me?

how much do you know about me?

please listen to the self-introduction of esophagus!

Hello, everyone, I am the esophagus, which connects the mouth and pharynx, and connects the stomach and intestines. Yes, it is the passage through which food enters the stomach in the human body. Many friends envy me very much, and I can taste all kinds of delicious food every day. I am also very happy. But after a long time, I found that food actually hurts me, alas, this is really a sweet burden! Delicious food, what should I do with you?

I am a muscular tube. After the food is swallowed through my mouth, it is delivered to my stomach. But I am very low-key. Under normal circumstances, you won't feel my presence unless the food is too big and choking, or the food is too hot or too cold. At this time, I will brush my presence in front of my host and remind him to care for me a little while enjoying the food.

let's watch my form together!

I am a long and narrow tube, about 25cm long, which is the narrowest part of the whole digestive system. My upper end meets the pharynx at the lower edge of the sixth cervical vertebra, and my lower end passes through the diaphragm into the abdominal cavity at the level of the tenth thoracic vertebra, and then extends slightly and then connects with the cardia of the stomach. Therefore, I was artificially divided into three parts: neck, chest and abdomen.

My three stenoses are related to these three segments. The first stenosis is at the junction with pharynx, the second stenosis is at the intersection with left main bronchus, and the third stenosis is at the position where esophagus passes through diaphragm. These three strictures are all caused by the special location, not my subjective will, but they are good places for foreign bodies to stay frequently, and even tumors love to join in the fun here, which has become a prone area for tumors.

Although my wall is very thin, it is composed of four layers of tissues, of which the innermost layer is the most delicate in direct contact with food, which is called mucosal epithelium, and my epithelial cells are growing. When the food exceeds 5, we will feel hot, and when it exceeds 65, my mucosa will be burned. You can think of me as a mineral water bottle. When warm water is poured into it, the bottle does not change. When hot water is poured over 65%, the bottle will be deformed. When hot water is poured into it, the bottle will be directly twisted and scrapped.

if you hurt me repeatedly for a long time, I must constantly repair my mucosal cells, which will cause me chronic inflammation. You know, the essence of cancer is gene mutation, and most gene mutations occur when cells replicate. Therefore, any factor that can increase cell replication can greatly increase the probability of gene mutation. Therefore, when my mucosa is chronically inflamed for a long time, I will continue to repair it. At this time, the probability of gene mutation will increase, which is the main reason why I eventually become cancerous.

Besides scalding food, many carcinogens in cigarettes, the stimulation of alcohol, nitrite in pickled food and aflatoxin in moldy food can directly stimulate my mucosa and induce gene mutation in my mucosal epithelial cells.

Although pickled food and moldy food cause cancer, it is a chronic and long-term process, and if you accidentally eat more pickled food or moldy food, nitrite or aflatoxin poisoning will be very fatal. A recent mass food poisoning incident in Jixi, Heilongjiang Province is a bloody example. A family of nine people ate contaminated sour soup, eight of which were not rescued, and one was still in the intensive care unit. Therefore, I would like to remind everyone here that we must be vigilant. For the sake of good health, we would rather waste it than take risks.

People in China always say that "food is the most important thing for the people", but in China, where the food culture is profound, the incidence of digestive system tumors remains high. For esophageal cancer, China accounts for almost half of the total number of esophageal cancer in the world. Henan is a high incidence area of esophageal cancer, and Linxian county is the most important one.

In recent years, with the intervention of medicine, esophageal cancer in Linxian County has been controlled, but it still ranks the third in the incidence of malignant tumors in China. Compared with its high incidence, the treatment of advanced esophageal cancer is not optimistic, and the five-year survival rate is less than 1%. Therefore, prevention, early diagnosis and early treatment are still the main points of prevention and treatment of esophageal cancer.

The early symptoms of esophageal cancer are atypical and easily overlooked. The most typical symptom of esophageal cancer in the middle and late stage is discomfort in different degrees when swallowing food, including choking sensation after swallowing food, burning-like, acupuncture-like, pulling-like pain behind the sternum, etc., which is characterized by progressive swallowing difficulty with food reflux in the later stage.

Progressive dysphagia is due to the gradual enlargement of the mass, which gradually aggravates the degree of esophageal obstruction. Food reflux is due to the increase of cancer, which leads to esophageal dilatation or food retention. Reflux is mucus-like, mixed with food, and bloody substances or necrotic tissue-like substances may be seen.

If there is sternum or back pain, it indicates that esophageal cancer has reached the advanced stage, and the cancer tissue has invaded other tissues around the esophagus. If the tumor compresses the recurrent laryngeal nerve, hoarseness may occur. When the tumor invades the adjacent organs and perforation occurs, esophagobronchial fistula, mediastinal abscess, pneumonia and lung abscess may occur, which may lead to death in severe cases. At the same time, it is accompanied by malnutrition, emaciation, dehydration, left supraclavicular lymph node enlargement and other metastatic sites.

The occurrence of esophageal cancer is related to smoking, alcohol, gastroesophageal reflux disease, Barrett's esophagus and genetic factors. At the same time, it has a very important relationship with bad eating habits, such as eating fast, eating hot soup and eating preserved food. In addition, the lack of some trace elements such as selenium, zinc, magnesium, molybdenum, etc., may also have a certain relationship with esophageal cancer.

Endoscopy: It is the most direct method to find and diagnose esophageal cancer. It can directly observe the shape of the lesion, and at the same time, it can directly take tissue for biopsy and dye suspected lesions with iodine, which can greatly improve the detection rate of early esophageal cancer.

Esophageal barium radiography: Normal esophageal mucosa is very smooth, very soft and flexible in dynamic state, while cancerous esophageal mucosa is tortuous and thickened, with interruption and filling defects in some places, and the esophageal wall is stiff and barium remains in dynamic state.

CT examination: it can show whether the esophageal wall is thickened, show the extent and scope of tumor invasion, and observe whether there is lymph node and abdominal cavity metastasis. But CT is not easy to find early esophageal cancer.

Histological and cytological examination: Finding cancer tissue in exfoliated cells is the most important method for cancer screening in high-incidence areas of esophageal cancer in China, with very high accuracy. Biopsy of metastatic lymph nodes and esophageal tissues is the gold standard for the diagnosis of esophageal cancer.

1. Develop good eating habits, slow down when eating, don't eat hot food and drinks, eat less pickled food such as kimchi and pickles, eat less fried food, don't eat moldy food, and try to eat more fruits and vegetables with balanced nutrition.

2. Quitting smoking and drinking, tobacco and alcohol have strong irritation to esophageal mucosa, which will induce gene mutation in mucosal epithelial cells for a long time.

3, regular physical examination, frequent use of kimchi and pickles, people who like hot and spicy food, people who often smoke and drink, need regular physical examination after 4 years old, and strive to kill cancer in the cradle. In particular, sudden dysphagia and dysphagia must be examined as soon as possible for early detection and treatment.

4. Actively treat other esophageal diseases. Patients with gastroesophageal reflux disease, esophageal polyps and other diseases must be actively treated and closely observed to prevent the disease from progressing to tumors.

Prevention is the most economical and effective health strategy. Everyone is the first responsible person for his own health, and the first manager of his own body and health, and bears health responsibilities to his family and society.

Take good care of the esophagus, starting with regular physical examination.