Endomicroscopy is an advanced endoscopic imaging technique that doctors at NYU Langone use to obtain real-time, microscopic images of esophageal tissue. This procedure is similar to an upper endoscopy, except your doctor inserts a tiny, powerful camera through the endoscope. Sometimes our specialists can identify precancerous cells in the esophagus using this technique. We can help you find a doctor.
Call or browse our specialists. If you need help accessing our website, call Skip to main content. Upper Endoscopy with Biopsy Doctors perform an upper endoscopy to identify any precancerous cells. Endomicroscopy Endomicroscopy is an advanced endoscopic imaging technique that doctors at NYU Langone use to obtain real-time, microscopic images of esophageal tissue. Accessed Aug. Understanding upper endoscopy. American Society for Gastrointestinal Endoscopy. Feldman M, et al.
Preparation for and complications of gastrointestinal endoscopy. Philadelphia, Pa. Goldman L, et al. Gastrointestinal endoscopy. In: Goldman-Cecil Medicine. Elsevier; The Merck Manual Professional Edition. Upper GI Endoscopy. Picco MF expert opinion. Mayo Clinic, Rochester, Minn. April 21, Mayo Clinic in Rochester, Minn. Learn more about this top honor. Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.
The doctor then inserts a scope a thin, lighted tube with a small video camera on the end through the incision to view the space around the esophagus. The surgeon can pass thin tools into the space to remove lymph nodes and biopsy samples to see if the cancer has spread.
This information is often important in deciding whether a person is likely to benefit from surgery. Usually if a suspected esophageal cancer is found on endoscopy or an imaging test, it is biopsied. In a biopsy , the doctor removes a small piece of tissue with a cutting instrument passed through the scope. HER2 testing: If esophageal cancer is found but is too advanced for surgery, your biopsy samples may be tested for the HER2 gene or protein. Some people with esophageal cancer make too much of the HER2 protein or gene which helps the cells grow.
A drug called trastuzumab Herceptin that targets the HER2 protein may help treat these advanced cancers when used along with chemotherapy. Only cancers that have too much of the HER2 gene or protein are likely to benefit from this drug, which is why doctors may test tumor samples for it. See Targeted Therapy for Esophageal Cancer. PD-L1 testing : An esophageal cancer that cannot be treated with surgery or has spread to distant sites may be tested to see if it makes a checkpoint protein called PD-L1.
Tumors that make this protein might be treated with the immunotherapy drug pembrolizumab. Esophageal cancers that test positive for MMR or high MSI and cannot be treated with surgery, have come back after initial treatment, or have spread to other parts of the body might benefit from immunotherapy with the drug pembrolizumab.
See Testing Biopsy and Cytology Specimens for Cancer to learn more about the types of biopsies, how the tissue is used in the lab to diagnose cancer, and what the results may show. Complete blood count CBC : This test measures the different types of cells in your blood. It can show if you have anemia too few red blood cells. Some people with esophageal cancer have low red blood cell counts because the tumor has been bleeding.
Liver enzymes: You may also have a blood test to check your liver function, because esophageal cancer can spread to the liver. Although this examination is very accurate, your doctor will take biopsies from the esophagus to confirm the diagnosis as well as look for the precancerous change of dysplasia that cannot be seen with the endoscopic appearance alone.
Taking biopsies from the esophagus through an endoscope only slightly lengthens the procedure time, causes no discomfort and rarely causes complications. Your doctor can usually tell you the results of your endoscopy after the procedure, but you will have to wait a few days for the biopsy results. It tends to occur in middle-aged Caucasian men who have had heartburn for many years. One recommendation is to screen patients older than 50 who have had significant heartburn or required regular use of medications to control heartburn for several years.
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