根據提供的文章標題，以下是新的文章標題建議： 1. 食道腫瘤的治療選擇：從初步診斷到進一步評估 2. 食道腫瘤的早期發現和治療：一個病例研究 3. 食道腫瘤的病理分析：一個深入探討 4. 食道腫瘤的治療策略：一個綜合性的評估 5. 食道腫瘤的預防和早期檢測：一個重要的議題 6. 食道腫瘤的治療進展：一個近期的研究摘要 7. 食道腫瘤的治療挑戰：一個臨床實踐的探討 8. 食道腫瘤的治療效果：一個長期隨訪的觀察 9. 食道腫瘤的治療風險：一個全面的評估 10. 食道腫瘤的治療選擇：一個多學科的討論-腫瘤科

食道腫瘤？

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20250815 診所上消化道內視鏡檢查報告

Indication : chest pain

Premedication : Nil

Findings :
Esophagus : Clear lumen.
Short mucosa break ＜5mm above SCJ. Esophageal mucosa lesion at 34cm level from incisor,
biopsy was done under consent.

Stomach : Clear lumen, good contraction and inflation. Reddish spots on mucosa at antrum. No mass

lesion noted. Rapid urease test was done under consent.

Duodenum : Negative down to proximal 2nd portion.

Impression : Gastroesophageal reflux disease,
LA grade A Esophageal mucosa lesion, s/p biopsy Erythematous gastritis

CLO test : negative

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20250820 病理中心 切片病理報告

臨床診斷: Mucosal lesion，r/o cancer
檢體來源: Esophagus

DIAGNOSIS:
Esophagus endoscopic biopsy，Carcinoma in situ at least(see note)

GROSS DESCRIPTION:
The specimen submitted consists of 4 tissue fragments measuring up to 0.3x0.2x0.1cm in size.
fix in formalin.
Grossly. they are gray and soft.
All for section

MICROSCOPIC DESCRIPTION:
Histologic features:
Tangentially-sampled neoplastic squamous epithelium.
exhibiting full-thickness epithelial dysplasia, composed of disordered squamous cells

Nuclear pleomorphism: Moderate, with occasional severe nuclear atypia
Atypical mitoses: Present
Keratinization: Present, focal
Subepithelial lamina propria: Scant, with lymphoid aggregation

Note:
Based on this biopsy specimen, carcinoma in situ at least is considered.
The interpretation is limited by the scantiness of subepithelial stroma.
The possibility of invasive carcinoma still has to be ruled out.
Further clinicopathological evaluation is suggested.

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20250826 A醫院上消化道泛內視鏡檢查

[Chief Complaint] esophageal tumor f/u

Pre-medication： Buscopan 20 mg IM

[Finding]
Esophagus: There is NBI suspect dysplatic mucosa
involving mid-lower esophagus at least 25-35cm from incisors,
and at least two ulcerative lesions about 0.5-1cm post biopsy (BX).
Failed further biopsy for dysplastic mucosa due to poor procedural tolerance.

Stomach: Gastric mucosa is uniform salmon color.
Gastric folds are soft and pliable.
The antrum is smooth. The pylorus is intact.

Duodenum: The scope was introduced into the 2nd portion.
There is no ulcer or scar in the bulb.

Complication: Nil

[Diagnosis]
1.Suspect Esophageal dysplasia with ulcerations,
post biopsy at one ulcer

2.*Poor tolerance for the procedure
and no further biopsy possible

3.*Consider sedated study with possible chromoendoscopy
and EUS evaluation by Dr.江

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20250915 B醫院病理組織檢查報告

收件日期: 20250912
報告日期: 20250915

組織由來: Esophageal cancer, 25cm below the incisor
臨床診斷: Esophageal cancer, 25cm below the incisor, s/p biopsy(A)

病理組織學診斷:
Esophagus, 25cm below the incisor, endoscopic biopsy, high-grade dysplasia at least

The specimen submitted consists of four tissue fragments measuring up to 0.2x0.2x0.1cm
in size fixed in formalin.

Grossly thay are white and soft.

All for section.

Microscopically, it shows squamous epithelium with irregular rete ridges and marked
cytological atypia.
The lamina propria shows dense lymphoplasma cell infiltration.
Rarescattered atypical cells at the periphery of the tissue are highlighted by Ck (AE1/AE3).
and the possibility of invasive carcinoma cannot be completely excluded.
high-grade dysplasia at least is considered.

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20250911 B醫院內視鏡超音波檢查過程紀錄與報告

檢查日期：2025/09/11 ​開始時間：14:03:39 ​結束時間： 14:51:07

Clinical diagnosis：
Esophageal cancer, for EUS staging

Indication：
Esophageal cancer, for EUS staging

Organ:
Esophagus

Instrument:
GIF H260Z.3
GIF-H290EC

Pre-medication:
Buscopan [Hyoscine]
Sedation / Anesthesla:
IVGA

Endoscopic Findings:
A 2 cm irregularly-shaped, hyperemic, erosive lesion was noted at 25 cm below
the incisors under white light image.
Under NBI + Magnifying endoscopy (ME),
this area appeared brownish with irregular intra-epithelial papillary
capillary loop (IPCL) and dilated vasculature,JES B2 pattern mostly.

However, several B3 like IPCL was also noted.
Chromoendoscopy with Lugol's solution disclosed large Lugol-voiding area with
pink color sign over the tumor. Biopsy was taken from this area (x2, labelled as A).
Some patchy Lugol-voiding areas were noted within upper esophagus.
Others: normal finding of gastric and duodenal mucosa.
After EUS was completed, endocytoscopy was performed, which disclosed several
foci of irregularly-arranged epithelial linings with irregular nuclei and
significantly enlarged, crowded nuclei, suggesting EC-3.

Endoscopic Ultrasound Findings:
EUS with Olympus UM-3R probe was performed.
A hypoechoic, focal lesion with involvement of the mucosal layer of
esophageal wall measuring up to 3.6mm in thickness was noted from 25 to 28cm below the incisors.
The margin of 3rd(submucosal) layer was intact.
The lesion was not invaded to adjacent structure including aorta, trachea, pericardium.
A 7.2 mm round, hypoechoic lesion was noted at the paraesophageal space.

Fine-Needle Aspiration

Diagnosis
1.Early esophageal cancer, 25-28cm below the incisors, s/p EUS staging,
cT1aN1Mx, s/p endocytoscopy, EC3, s/p biopsy (A)
​2.Paraesophageal lymphadenopathy

Preliminary Cytology Diagnosis
nil

Suggestion
Please pursue pathology report

======================

已做檢查:

A醫院
8/26 胸部CT
8/26 上消化道內視鏡

B醫院
8/28 支氣管鏡(正常)
9/04 食道鏡(咽喉部正常)
9/09 頭/頭頸/腹部CT
9/11 E.U.S超音波內視鏡
9/17 全身正子掃描
9/19 UGI上腸胃道造影

20250901 回診
A醫院胸腔外科醫師說: 切片可能不完整，沒驗到癌細胞
我說:有可能是原味癌嗎?
醫師說:不可能，看起來應該是1期，要等後面的檢查結果才能確認，
如果是1期就會幫我轉給腸胃科醫師用內視鏡處理...

20250915 回診
B醫院胸腔外科醫師說: 超音波內視鏡看起來是1期沒錯，用ESD剝離手術即可，
但是在腫瘤的下方旁邊有一個陰影要再確認是不是轉移，如果是，那就必須做食道切除一截手術

請教一下...

1.如果是1期，為什麼要轉腸胃科處理?

2.假設是輕微的食道腫瘤，也做了剝離術（ESD），後續還有可能需要電療化療嗎?

3.食道腫瘤原因:抽菸/喝酒/檳榔/胃食道逆流/喝太燙，我的部位在靠近胃，我已戒酒7-8年
那我的腫瘤原因比較大的可能是胃食道逆流造成的，對嗎?

4.A 7.2 mm round, hypoechoic lesion was noted at the paraesophageal space.
在食道旁空間發現一個 7.2 毫米的圓形低迴音病灶。
這個就是B醫院醫師說的陰影嗎?

5.Diagnosis: 2.Paraesophageal lymphadenopathy 「食道旁淋巴結腫大」
這個跟上一個說的陰影是相同東西嗎?

6.食道旁淋巴結腫大: 食道旁大約有幾個淋巴結? 腫瘤旁邊的淋巴結?

7.EUS分期cT1aN1Mx，T1N1不是指食道癌第2期嗎? 那怎麼會寫是Early esophageal cancer ?

8.同上，N1表示癌細胞已擴散到附近的淋巴結，那怎麼說可以用ESD剝離手術就好?

9.T1a 腫瘤只侵犯到固有層 (Lamina propria)沒有到肌肉層，那在肌肉層下方的淋巴結，怎麼會是N1?

10.B醫院醫師說:腫瘤的下方旁邊有一個陰影要再確認是不是轉移，如果是，那就必須做食道切除一截手術
​那我可以腫瘤部分用ESD，陰影部分用電療嗎? 這樣就不用切除一截食道...

11另依我的情形來看，有什麼比較好的建議嗎?

以上麻煩您了，感謝~

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五百，50~59歲男性，詢問日期：2025/09/21