The most common etiology of esophageal SCC, as alcohol and tobacco use, nutrition and environmental factors, genetics and the Human Papilloma Virus (HPV) is observed. Predisposing factors of esophagitis, esophageal stasis syndrome, achalasia, caustic burns, alkali corrosion, diverticulum, Plummer-Vinson syndrome, celiac disease, previous gastric resection, previous radiotherapy include app. ADC in the etiology of gastroesophageal reflux disease, Barrett's esophagus, smoking and obesity play a role.
Alcohol and tobacco: the use of alcohol and tobacco in America, Europe and especially France, the most important etiological factor. In chronic smokers who consume alcohol have an increased risk of 20-25, according to times. Tobacco use increases the risk 2-6 fold. With the termination of the use of tobacco, the risk declines by 40%. Strengthen each other's effect when used with alcohol and cigarettes, increase the risk 10-25 times.
Nutrition: Another common feature is the high-risk areas, rich in cereals, whereas the A, C, vitamin E, folic acid, riboflavin, animal protein, fat, fresh fruit and vegetables, lack of or poor nutrition. High vitamin C, beta-carotene are yellow and green vegetables reduces the incidence of SCC.
Carcinogenic substances formed by means of microbial contamination in some foods directly by taking the risk is increased. For example, when corn infected with fungi is composed of nitrosamine derivatives. In addition, the sheer number of vegetables are carcinogenic effect of the molds, and particularly increases the risk of SCC.
Significantly increases the risk of excessive hot food to be continuous.
Trace element deficiencies have also played a role in the empirical studies. One study demonstrated the protective effect of molybdenum-rich diet. In another study, zinc plays a role in epithelial differentiation, cytochemistry events shown to be effective. In addition, zinc deficiency in guinea pigs esophageal mucosa, such as the epithelial changes consisted of hyperkeratosis and acanthosis. Sauvaget and regions with high incidence of SCC zinc, selenium, and reported low levels of molybdenum.
Inheritance: China and Iran, especially in an area north-east of the incidence of esophageal cancer suggests a hereditary factor may be. Also known as hand-foot Plantaris, which leads to an autosomal dominant inherited disease, esophagus cancer by 1 / 3 is observed. Esophageal cancer, one showing the genetic relationship, the best example.
Esophageal cancers, 2 / 3 of the p53 mutation, but the most important oncogene in the pathogenesis cyclin.
Human papillomavirus (HPV): Especially with high-incidence regions of China and South Africa, 40-In 60% of patients with HPV DNA found in SCC. HPV16 and HPV18 may play a role in some cases, esophageal SCC.
Celiac disease: usually increases the incidence of gastrointestinal cancer and lymphoma. Considered to be due to lack of trace elements and vitamins.
Plummer-Vinson (Patterson-Kelly) syndrome: atropine glossopati, dysphagia, and severe iron deficiency anemia seen in this syndrome, especially in the upper esophagus and mouth to develop cancer by 10%.
Achalasia: 30-fold increased risk in these patients with the incidence of SCC is usually placed in the middle of the esophagus ranged from 1-20%.
Diverticula: 0.3-0.7% patients, usually after age 60
percent may develop cancer.
Esophagitis: Extremely hot foods causes chronic esophagitis. This is seen in patients with SCC, especially in the middle and lower esophagus.
Esophageal strictures: as a result of burns due to caustic substances strictures, the risk of SCC increase 20-fold compared to ordinary people. Caustic burns to occur increases, especially in the age of cancer occurrence time is reduced. Food stasis occurs as a result of strictures. Before extending the duration of the contact you have with this nitrozaminlerle esophagitis, after many years can cause epithelial hyperplazisine.
Previous gastric resection: pre-partial gastrectomy in people who would be an increase in the incidence of lower esophageal SCC. The reason for this poor-poor nutrition, and gastroesophageal reflux. The latent period for the formation of cancer in approximately 20-25 years.
Previous radiation therapy: the cervical spine, breast and thyroid after radiotherapy may develop SCC. Period of 50 years, sometimes with the irradiation of cancer development can pass.
Thyroid Gland and Thyroid Hormone Physiology
Embryology and Histology
Thyroid gland during embryological development of the language develops in part through the foramen cecum. Thyroglossal tract of fetal life through the 7th reaches the front side of the neck in the week.
A typical adult weighs 15-20 grams. Slightly smaller than in women. Below the cricoid cartilage, located in front of the trachea.
Cloth, cuboidal and furnished by the follicle epithelium is composed of columnar cells. Colloid in the lumen of the follicles in the middle of 50-75% by weight of the entire gland creates.
B. Thyroid Hormone Physiology
Iodine is required for the synthesis of thyroid hormones. Thyroid follicle cells, plasma membrane protein, iodine through the APR take (capture). The iodine is then oxidized thyroid, tyrosine residues on Tg is connected to the structure of the glycoprotein. The resulting (MIT) and (DIT), thyroxine (T4) and triiodothyronine (T3) 's through to create a combined peroxidase. T3 and T4 hormones to accumulate in the follicle colloid filled lumen. Thyroid hormones are released as a result of hydrolysis of plasma TG.
Pituitary thyroid-stimulating hormone (TSH), the capture of iodine, and thyroid hormone secretion checks. Thyroid-pituitary feedback mechanism is sensitive to the blood level of thyroid hormone and TSH secretion, which controls the dominant mechanism. T4 is the main hormone secreted by the thyroid gland, thyroid transporter proteins in peripheral tissues, and moved here more active metabolically converted to T3.
TSH secretion in response to a small amount of colloid and surrounded by epithelial cells of thyroid hormones into the blood during result of TG in the blood can pass a very small percentage of Tg. TG is used as an indicator of tumor-differentiated thyroid cancer total thyroidectomy and iodine-131 (I-131) after ablation shows a high rate of recurrence detection.
Thyroid gland during embryological development of the language develops in part through the foramen cecum. Thyroglossal tract of fetal life through the 7th reaches the front side of the neck in the week.
A typical adult weighs 15-20 grams. Slightly smaller than in women. Below the cricoid cartilage, located in front of the trachea.
Cloth, cuboidal and furnished by the follicle epithelium is composed of columnar cells. Colloid in the lumen of the follicles in the middle of 50-75% by weight of the entire gland creates.
B. Thyroid Hormone Physiology
Iodine is required for the synthesis of thyroid hormones. Thyroid follicle cells, plasma membrane protein, iodine through the APR take (capture). The iodine is then oxidized thyroid, tyrosine residues on Tg is connected to the structure of the glycoprotein. The resulting (MIT) and (DIT), thyroxine (T4) and triiodothyronine (T3) 's through to create a combined peroxidase. T3 and T4 hormones to accumulate in the follicle colloid filled lumen. Thyroid hormones are released as a result of hydrolysis of plasma TG.
Pituitary thyroid-stimulating hormone (TSH), the capture of iodine, and thyroid hormone secretion checks. Thyroid-pituitary feedback mechanism is sensitive to the blood level of thyroid hormone and TSH secretion, which controls the dominant mechanism. T4 is the main hormone secreted by the thyroid gland, thyroid transporter proteins in peripheral tissues, and moved here more active metabolically converted to T3.
TSH secretion in response to a small amount of colloid and surrounded by epithelial cells of thyroid hormones into the blood during result of TG in the blood can pass a very small percentage of Tg. TG is used as an indicator of tumor-differentiated thyroid cancer total thyroidectomy and iodine-131 (I-131) after ablation shows a high rate of recurrence detection.
What is Thyroid Papillary Cancer
The most common type of thyroid cancer (70-80%) with papillary thyroid cancer usually occurs 30-40 years of age and gender incidence is 1 to 3. More common in iodine-rich areas. The main type of cancer seen in children after exposure to radiation. Ret oncogene activation is located in the etiological factor.
Low malignant potential. With proper treatment, a 10-year survival of 80-90% (8). Tumor with cystic or solid, or encapsulated into the thyroid, the thyroid capsule, or may have spread to surrounding tissues. Macroscopic calcification and necrosis may occur. Microscopic papillary structures as a small, ground-glass appearance and is typical to see psammoma corpuscles. Desmoplasia reaction in tumors that are common.
The characteristic feature of lymph node infiltration. Can occur in more than 75% of the cases together, the prognosis is controversial effect. Distant metastases are uncommon (5-10%). If we see most often in the lungs, more rarely in the bones, liver and brain, is determined.
According to the WHO classification, papillary carcinoma, classical type, except there are some histopathological subtypes. These follicular, Oncocyte, clear cell, diffuse sclerosing, high-cell, columnar cell, and solid variants. ATA 2009 manual high-cell, columnar cell and diffuse sclerosing types is actually a worse prognosis. Cribriform cancer, papillary thyroid cancer in subgroups according to the same classification as adopted, with focal insular component of papillary cancers were evaluated separately.
The other group is assessed by the WHO classification of papillary separate headings. Under 1 cm, these tumors are incidentally detected papillary thyroid cancers are the most common. Invasion, as long as they did not carry an indication for ablation. Although multicentric iodine treatment should be given to the former guideline emphasized the ATA in 2009, the revised manual is frequent recurrences in this group, but iodine treatment this recurrences frequency reduce highlighted, For this reason, iodine treatment in this patient group was to be a certain indication.
Low malignant potential. With proper treatment, a 10-year survival of 80-90% (8). Tumor with cystic or solid, or encapsulated into the thyroid, the thyroid capsule, or may have spread to surrounding tissues. Macroscopic calcification and necrosis may occur. Microscopic papillary structures as a small, ground-glass appearance and is typical to see psammoma corpuscles. Desmoplasia reaction in tumors that are common.
The characteristic feature of lymph node infiltration. Can occur in more than 75% of the cases together, the prognosis is controversial effect. Distant metastases are uncommon (5-10%). If we see most often in the lungs, more rarely in the bones, liver and brain, is determined.
According to the WHO classification, papillary carcinoma, classical type, except there are some histopathological subtypes. These follicular, Oncocyte, clear cell, diffuse sclerosing, high-cell, columnar cell, and solid variants. ATA 2009 manual high-cell, columnar cell and diffuse sclerosing types is actually a worse prognosis. Cribriform cancer, papillary thyroid cancer in subgroups according to the same classification as adopted, with focal insular component of papillary cancers were evaluated separately.
The other group is assessed by the WHO classification of papillary separate headings. Under 1 cm, these tumors are incidentally detected papillary thyroid cancers are the most common. Invasion, as long as they did not carry an indication for ablation. Although multicentric iodine treatment should be given to the former guideline emphasized the ATA in 2009, the revised manual is frequent recurrences in this group, but iodine treatment this recurrences frequency reduce highlighted, For this reason, iodine treatment in this patient group was to be a certain indication.
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