Complaints about the patient for the presence of dysphagia, history, confirming the systematic and progression of symptoms, are sufficient reason to suspect cancer of the esophagus. Observation of the patient can rarely provide any convincing evidence for the diagnosis of esophageal cancer. Patients with severe dysphagia and malnutrition are usually exhausted.

The main method of diagnosis of esophageal cancer is the x-ray. The method allows to determine the shape of tumor growth, location, extent, there are a number of complications. Important landmarks are skeletotopicheskie characteristics of the various departments of the esophagus. Radiologically the most persistent symptoms of esophageal cancer are:

• absence of the wall of the esophagus at the site location of the tumor
• violation of the relief mucosal wall of the esophagus,
• filling defect,
• narrowing of the lumen and infiltration of the wall body.

With the spread of X-ray point narrowing of the lumen of the esophagus to the formation of a narrow rigid tube with an uneven, lumpy edges until complete stenosis of the esophagus with the development of suprastenoticheskogo expanding body. Upon germination the tumor in the mediastinum and its decay can be traced back niche, often going beyond the walls of the esophagus. In the formation of esophageal-tracheal or bronchial-esophageal fistula contrast swallowing enters the respiratory tract and contrasts them.

To clarify the boundaries of the tumor vnepischevodnogo resort to radiography and tomography in pnevmomediastinuma that allows X-rays to determine the outer contours of the esophagus, more distinctly contrasting shade of the tumor. Certain value represent some of the angiographic study - azygography.

Application of computer tomography largely eliminates the invasive methods of investigation in solving the problem of the penetration of the tumor beyond the esophagus. Computer tomography used in the diagnosis of metastatic lesion of the liver, lymph nodes, abdominal cavity.

Esophagoscopy is a mandatory method of investigation for suspected cancer of the esophagus. The method is intended to clarify the localization of tumor, extent of injury, identify the presence of multiple mucosal injury, to identify the background state of the mucosa of the esophagus. There are recognized as benchmarks in determining the level of destruction peschevoda: the upper third of the esophagus is located at 18-24 cm from the edge of the upper incisors, the middle one-third - in the 24-32 cm from the incisors and the lower one-third - from 32 to 40 cm

However, esophagoscopy should be preceded by X-ray study. During the endoscopic examination in almost all cases it is possible to produce a tumor biopsy or take the material for cytological study. Positive results of morphological studies (detection of cancer cells in the material) make the diagnosis certain. The comparative simplicity of the fence material for morphological study during esophagoscopy allows for morphological confirmation of the diagnosis in 85-92% of cases.

Traheobronhoskopiya performed to identify the primary tumor multiplicity of the process (the defeat of the bronchial tree synchronous tumors), or germination of tumors of the esophagus into the bronchial tubes, bronchi during germination is mandatory tumor biopsies for morphological verification process.

Laparoscopic possible to carry out morphological evidence of metastatic lesions of the liver, lymph nodes, identify kantseromatoz peritoneum, the presence of ascites.

Ultrasound is performed to detect metastatic lesions of the liver, detection of enlarged lymph nodes in the regional areas below the diaphragm and accessible areas of the mediastinum, retroperitoneal fat, vnutristenochnogo evaluation of the tumor (in cases when it is possible to hold within the zone of narrowing of the esophagus Transesophageal ultrasound probe).

Ultrasound of the neck, supraclavicular zones assists in identifying metastatic lymph nodes.

Thus, the integrated use of X-ray, esophagoscopy, Morphology of the material allows, in most cases correctly identify the disease. In some cases, it is necessary to differentiate esophageal cancer diseases such as kardiospazm, cicatricial stricture of the esophagus, diverticula, benign tumors and ulcers of the esophagus.

These diseases distinguish long-term trend, have a characteristic X-ray picture. Crucial to exclude a malignant process (independent and developing on the background of these changes) have negative rezultty morphological study of biopsy material from the esophagus.

Important place in the diagnostic process took clinically e and functional studies. Clinical and biochemical blood tests, assessment of coagulation system, the degree of electrolyte, protein disorders allow for preoperative correction of existing violations. Conduct electrocardiography, when indicated - echocardiography in conjunction with spirography reveals the degree of functional disorders of the respiratory and cardiovascular systems, which is a decisive factor in choosing a method of curing the patient.