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Увеличиваясь в размерах, новообразование частично или полностью перекрывает просвет пищевода, прорастает сквозь его стенку и распространяется на находящиеся рядом органы [1](https://www.medicina.ru/patsientam/zabolevanija/rak-pishchevoda/). \n\nПо гистологическим признакам рак пищевода подразделяют на [1](https://www.medicina.ru/patsientam/zabolevanija/rak-pishchevoda/): \n* **Плоскоклеточный** — развивается из эпителиальных плоских клеток, бывает поверхностным и глубоко-инвазивным [1](https://www.medicina.ru/patsientam/zabolevanija/rak-pishchevoda/)[5](https://fnkc-fmba.ru/zabolevaniya/rak-pishchevoda/). \n* **Аденокарцинома** — развивается из клеток, вырабатывающих защитную слизь [1](https://www.medicina.ru/patsientam/zabolevanija/rak-pishchevoda/)[5](https://fnkc-fmba.ru/zabolevaniya/rak-pishchevoda/). \n\nПо расположению различают опухоли верхней (10%), средней (35%) и нижней (55%) части пищевода [1](https://www.medicina.ru/patsientam/zabolevanija/rak-pishchevoda/).\n\n\n\n## Причины\nТочных причин развития рака пищевода врачи не знают, но известны факторы, которые повышают вероятность заболевания [6](https://lapino2.ru/napravleniya/torakoabdominalnaya-onkologiya/rak-pishchevoda/). Некоторые из них: \n* курение и употребление крепких спиртных напитков, обжигающих слизистую пищевода [1](https://www.medicina.ru/patsientam/zabolevanija/rak-pishchevoda/)[4](https://polyclinika.ru/tech/rak-pishchevoda-simptomy-stadii-lechenie-prognoz/); \n* заглатывание очень горячей и слишком холодной пищи, приводящей к раздражению и травмированию слизистой оболочки [4](https://polyclinika.ru/tech/rak-pishchevoda-simptomy-stadii-lechenie-prognoz/); \n* хронические воспалительные заболевания, например, «пищевод Баррета» — разрастание в стенках органа клеток, выстилающих желудок и тонкий кишечник [6](https://lapino2.ru/napravleniya/torakoabdominalnaya-onkologiya/rak-pishchevoda/).\n\n## Симптомы\nНа начальных этапах рак может никак себя не проявлять [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). По мере роста опухоли появляются следующие симптомы [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/): \n* **Дисфагия** — затруднение при глотании [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). Изначально возникают трудности с приёмом твёрдой пищи, затем — с полужидкими блюдами, после чего наступают сложности с проглатыванием жидкости [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). \n* **Потеря веса** [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). \n* **Ощущение жжения или боли за грудиной** [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). \n* **Изжога, отрыжка** [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). \n* **Охриплость голоса** и длительный кашель [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). \n* **Общая слабость, бледность кожи** [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). \n* **В случае внутреннего кровотечения** — кровь в рвотных массах и чёрный стул [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/).\n\n## Диагностика\nПри подозрении на рак пищевода необходимо обратиться к гастроэнтерологу или онкологу [8](https://uteka.ru/articles/bolezni/rak-pishchevoda/). Некоторые методы диагностики: \n* **Эндоскопическое исследование** — основной метод визуализации опухоли, позволяет оценить состояние слизистой оболочки пищевода, выявить новообразование, его форму и распространённость [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). \n* **Биопсия и гистологическое исследование** — выполняется во время эндоскопии, позволяет точно определить тип опухоли, степень злокачественности и наличие инвазии в окружающие ткани [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). \n* **Лучевая диагностика** — определяет размеры опухоли, поражение лимфоузлов, возможные метастазы [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/).\n\n## Лечение\nПодход к терапии определяется индивидуально [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). Некоторые методы лечения: \n* **Радикальное лечение** — полное удаление опухоли, чаще всего хирургическим путём [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). Обычно проводится в сочетании с химио- или лучевой терапией для повышения эффективности [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). \n* **Лучевое лечение** — используется для уничтожения опухолевых клеток, уменьшения размеров новообразования и профилактики рецидивов [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). Может применяться как до, так и после операции или как самостоятельный метод [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). \n* **Паллиативное лечение** — применяется на поздних стадиях и направлено на облегчение симптомов, улучшение глотания и качества жизни [11](https://www.oncology-centr.ru/diseases/onkologicheskie-zabolevaniya-organov-zhkt/rak-pishchevoda/). 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