Esophageal Adenocarcinoma Methods and Protocols

4

treatment clinical staging of the disease to decide the manage-

ment of the patient. Endoscopic ultrasound (EUS) uses an

endoscope with a probe, which releases sound waves that can

help to study if the adenocarcinoma has spread into the esoph-

ageal wall or lymph nodes.

Advanced stage adenocarcinomas are often treated by chemo-

therapy and radiotherapy before definite surgery (see Chapters 2

and 3 ). In early lesions (including dysplasia), local resection by

endoscope may be used. The procedure used could be endoscopic

mucosal resection followed by radiofrequency ablation. Endoscopic

submucosal dissection may also be used [ 10 , 11 ].

Fig. 2 Microscopic examination of gastric mucosa showing the Helicobacter

pylori (brown color) identified by immunohistochemical stain

Fig. 3 Adenocarcinoma of the esophagogastric junction

Alfred K. Lam