The first stenosis: the beginning of the esophagus, equivalent to the level of the lower edge of the sixth cervical vertebra, about 15cm from the central incisor; Second stenosis: the esophagus is behind the left main bronchus and its intersection, equivalent to the level between the 4th and 5th thoracic vertebrae, about 25cm from the central incisor; Third stenosis: The esophageal hiatus where the esophagus passes through the diaphragm, which is equivalent to the level of the tenth thoracic vertebra and about 40cm away from the central incisor.

When collecting materials, basic information should be checked, such as name, department to be sent for examination, bed number, hospitalization number, specimen type, etc.

When collecting all mucosal samples for examination, the mucosa should be wrapped in filter paper to avoid loss. Eosin should be added dropwise when collecting the samples to facilitate identification by technicians during embedding and sectioning.

General examination and records

Color, lesion, whether the outline of the lesion is regular, whether there is obvious bulge or depression, whether there is erosion or ulcer, etc., and the distance between the lesion and each incision edge (at least the closest distance between the lesion and the mucosal side incision edge).

All materials. It is advisable to apply iodine to identify the lesion (iodine-unstained area) and the proximal resection edge, and take the material perpendicular to the proximal resection edge. The mucosal lateral incision edge and basal incision edge can be marked with ink or carbon ink. Samples from the esophagogastric junction should be collected along the oral-anal direction. Make parallel cuts at intervals of 2-3mm, take all the materials, and bury them vertically in the same direction. It is recommended that multiple resected specimens be numbered and sampled separately without considering the lateral resection margins.

General examination and records

Esophageal length, tumor location, distance from the tumor to the oral and anal resection margins and circumferential resection margins, tumor general type, size, cut surface color, texture, depth of invasion, involvement/non-involvement of the esophagogastric junction (esophagogastric involvement) For the junction, record the distance between the tumor center and the esophagogastric junction), the examination findings of the esophageal mucosa/muscle wall next to or around the tumor, the size and section of each lymph node group. It is recommended to use Siewert classification for adenocarcinoma of the esophagogastric junction.

Apply iodine when necessary to identify lesions (areas not stained by iodine). A strip of tissue can be taken from the center of the tumor from the oral resection edge to the anal resection edge for embedding (including the tumor, adjacent mucosa, and resection margins at both ends), and the corresponding orientation of the tissue block should be recorded (photos or schematics should be attached and marked) ). It is recommended to take the relationship between the two ends of the resection margin and the tumor longitudinally. For tumors far away from the two ends of the resection margin, the two ends of the resection margin can also be taken transversely. The incisal edges of the closers submitted for separate inspection should be removed and all materials should be collected and observed. Focus on collecting materials from the deepest part of tumor invasion and suspected circumferential resection margin involvement. It is recommended to use ink or carbon ink to mark the circumferential resection margin. Samples should be taken separately from areas with changes such as erosion, roughness or non-staining of iodine in the surrounding mucosa or surrounding nodules within the esophageal/gastric wall and the esophagogastric junction. All grouped lymph nodes submitted for examination should be embedded and harvested. If the mediastinal pleura, lungs, diaphragm and other adjacent organs are attached, materials should be observed and collected. For early-stage esophageal cancer or radical resection specimens after neoadjuvant treatment, it is recommended to collect all suspicious lesions and tumor beds.