A GENERAL PRESENTATION ABOUT esophageal squamous cell carcinoma

2. Anatomically
Hollow muscular tube
about 25 cm long which
extend from pharynx to
gastroesophageal junction
of stomach
Histologically 4 layer :
1. Serosa
2. Muscularis
3. Submucosa
4. Mucosa

3.  The upper third
is drained into the
deep cervical nodes
 The Middle third
is drained into the
upper and lower
mediastinal nodes
 The lower third
is drained into the
celiac lymph node

4. • Esophageal cancer can
occur when a malignant
tumor form at the lining of
the esophagus.
• As the tumor grow can
effect the deep tissue and
muscle of the esophagus
•Tumor can appear
anywhere along the length
of esophagus

5. 1) Squamous cell carcinoma (ESCC) :
Occur when the cancer start in flat thin cell that
make up the lining of the esophagus and this
form can appear any where along esophagus
Main cause : tobacco , alcohol

6. 2) Adenocarcinoma (EAC) :
Occur when the cancer starts in glandular
cells of esophagus that are responsible for
the production of fluid within the esophagus
such as mucus (most common of lower
portion in esophagus and main cause with
GERD and Barrett's esophagus)

7.  As with most cancers the cause of
esophageal cancer is not well known but it’s
related to abnormalities or mutations of the
DNA of the esophagus.
 These mutations signal the cells to
multiply more rapidly than normal cells and
also disrupt the signal for these cells to die
(apoptosis) when they should and this causes
them to accumulate as tumors

8. CANCER : defined as when abnormal cells divide in an
uncontrolled way
CHEMICALS
RADIATIONS
VIRUSES
NORMAL
CELL
DNA DAMAGE
DEFECTIVE CELLS
FAILURE OF DNA
REPAIR
CELLS
MULTIPLY
TUMOR
FORMATIONMETASTASIS

9. TP53 (Most common)
PIK3CA
KMT2D
FAT1
FAT2
NOTCH1
ZNF750
HER/NEU

11. TP53 GENE:
 In human the TP53 is
Located on the short
arm of chromosome
17 , and encodes at least
15 protein isoforms
 Encodes the protein that bind to DNA and
regulate gene expression to prevent mutation of
the genome

12. Play a big role in regulating cell death
(apoptosis) ,suppressing tumors regulating
cell cycle and stopping the cell from dividing
when the DNA is damaged
 TP53 gene is the most frequently mutated
gene , more than %50 of human cancer

13.  Activate DNA ,repairs
protein when DNA has been
damaged and arrest growth
by holding the cell cycle at
the G1-S regulating point
 It can initiate apoptosis if
DNA damage can not be
repaired
 P53 acts as a brake pedal
for the cell cycle

20.  In the most cases
inactivation of the TP53 tumor
suppresser is a frequent event
in tumorogenesis
 Mutant P53 proteins not
only lose their tumor
suppressing activities but also
give rise to a stable mutant
protein whose accumulation is
regarded as a hall mark for
cancer cells

22. The stages of this cancer are
classified according to the TNM
(Tumor ,Node and Metastasis)
The stages are:
Stage 0 : include Tis,N0,M0
Stage 1 : include
T1,T2,T3,N0,M0,G,G1
Stage 2 : include
T1,T2,T3,N1M0T
Stage 3 : include
T3,T4a,T4b,N1,N2,N3,M0
Stage 4 : include T,N,M1,G

41.  Experts believe that the irritation of
esophageal cells contribute to the development
of this cancer.
 Habits that cause irritation include:
•Smoking
•Dinking alcohol
•Gastroesophageal reflux disease
(GERD)
•Drinking hot foods
•Being overweight
•Insufficient consumption of fruit and vegetable

42.  During early stage you probably won’t notice
any symptom
 As your cancer progresses you may express :
• Severe weight loss
• Indigestion
• Heart burn
• Difficulty or painful swallowing
• Frequent chocking while eating
• Vomiting
• Fatigue
• Chest pain
• Regurgitation

43. Esophageal cancer is the 7th leading cause of
cancer deaths
The incidence rises steadily with age reaching
the 5th to 7th decade of life
Men are more than 3 times as likely as women to
get esophageal cancer ,because(male consume
alcohol and smokingmore than female)

44. Most common in China ,Iran
,South Africa, India and Japan

45. Testing methods include
the following :
1) An endoscopy involves
the use of an instrument
with a camera which
allows the doctor to
view the lining of
esophagus to check for
abnormalities and
irritations.

46. 2) X-ray imaging
test allows you to
see the lining of
the esophagus (to
do this you will
swallow a chemical
called barium while
the images are
being obtained).

47. 3)Biopsy is a
process in which
you remove a
sample of the
suspicious tissue
with the help of an
endoscope and
send it to the lab
for testing .

48. 1)Surgery
A) if cancer hasn’t grown past the superficial
layers of the esophagus then the doctor can
remove the tumor within an endoscope.

49. B) In serious cases a portion of the esophagus
and the lymph nodes around it are removed
and the tube is reconstructed with a tissue
from the stomach or the large intestine

50. 2) Chemotherapy
Involves the use of drugs to attack cancer
cells and may be used before or after surgery.
And chemotherapy may be accompanied by
the use of radiation therapy.
3) Radiation therapy
Uses beams of radiation to kill cancer cells.
Radiation may be administered externally
with the use of a machine or internally with
a device placed near the tumor.