食道癌 Esophageal Cancer
認識食道癌
食道是一條連接咽喉到胃部的管狀器官，
長約25至33厘米，
而發生在這部位的惡性腫瘤便稱為食道癌。1,2
食道癌是甚麼？
食道癌種類
食道癌可以從食道任何位置開始，由食道壁的內層逐步向外層生長，並因應癌變發生的細胞類型大致分為兩大類3-5：
食道腺癌 （Esophageal adenocarcinoma）
約佔食道癌20%病例
食道鱗狀細胞癌
(Esophageal squamous cell carcinoma, ESCC)
約佔食道癌80%病例
由於本港的食道癌個案以鱗狀細胞癌為主，故此食道癌亦一般是指食道鱗狀細胞癌。
食道癌統計數字
雖然食道癌並非本港十大常見癌症之一，但卻排行本港致命癌症的第十位，反映食道癌是一種高致命率的癌症。6 食道癌在亞洲地區的發病率亦比歐美等西方國家為高，估計與亞洲人的飲食習慣有關。7 而在香港，每4個確診患者中，就有約3個會因食道癌而死亡。6,8-10
在2022年，本港錄得371宗食道癌新症，而死亡個案則有286宗。8-10 男性患上食道癌的機會比女性為高，佔新症總數的約8成。8,9
食道癌的成因
患上食道癌的原因至今尚未有定論，但可能與多種風險因素有關，包括11-14：
-
年紀愈大，尤其55歲過後
-
男性
-
嗜酒
-
吸煙
-
肥胖
-
飲食習慣，如：經常吃用醃製和加工食物，長期飲用滾燙飲料、湯水，少吃蔬果
-
患有胃酸倒流/巴洛氏食道症
-
某些罕見的疾病（如賁門失弛緩症）和遺傳性基因突變如磷酸酯酶與張力蛋白同源物（PTEN）基因和黑斑息肉症候群（Peutz-Jeghers Syndrome）
食道癌症狀
食道癌的早期症狀不明顯，即使出現最常見症狀之一的吞嚥障礙，患者也可能不以為然或改變進食習慣應對，以致大部分個案確診時腫瘤已進入較末期階段。15-18
吞嚥困難加劇，逐漸只能進食半流質食物，甚至連流質和口水也無法吞下
食道癌分期
醫生會根據腫瘤的大小及影響範圍(T)、入侵淋巴結的情況(N)，以及是否有遠端轉移(M)，為食道癌患者進行分期。19 而腫瘤所在位置也可能會影響食道癌分期。
此外，食道癌也會以細胞形態分為1到3級。第1級代表癌細胞看起來像正常食道細胞，第3級代表癌細胞看起來十分異常，而第2級則介乎第1級與3級之間。分級愈低則腫瘤的生長和擴散速度通常較慢，預期前景也較為理想。19
診斷及生物標記檢測
如果醫生懷疑患者可能有食道癌，除了檢視病歷及臨床檢查外，更可能會建議及安排進行以下的檢查，包括20,21：
-
食道內視鏡檢查
-
內視鏡超聲波檢查
-
支氣管內視鏡檢查
-
活組織檢驗
-
食道及胃部鋇劑造影檢查
-
血液檢查
有時患者可能需要進行進一步檢查，以便醫生更全面評估腫瘤狀況，例如電腦掃描及正電子掃描等。20,21
確診後，醫生可能會因應病況建議進行檢測，如腫瘤生物標記，檢測項目可能有20,22,23：
-
PD-L1蛋白水平
-
微衞星不穩定性（MSI）及錯配修復基因（MMR）
-
突變負荷
-
HER2基因或蛋白
食道癌治療方案
食道癌的治療會因應患者的狀況和腫瘤特性而有所不同。一般來說，早期食道癌可以手術及放射治療清除腫瘤，有需要時可加入化療降低復發風險。至於較晚期且無法以手術切除或放射治療清除的食道癌則可以化療或加入免疫治療作一線治療。25,26
早期及晚期食道癌的治療會不一樣，可能需要採取的治療方案包括26,27:
-
這類食道癌通常難以完全根治，但可透過適當治療緩解症狀及盡量延長存活期
-
患者一般以化療去控制病情，亦可加入標靶治療或免疫治療以控制病情
-
對於在胃食道交界的食道癌：
-
可以考慮使用標靶藥物或加入化療處理，亦可以採用免疫治療或免疫治療加化療進行治療
-
如果腫瘤屬HER2陽性，標靶治療加免疫治療合併化療可作為首選治療方案
-
這類食道癌通常難以完全根治，但可透過適當治療緩解症狀及盡量延長存活期
-
患者一般以化療去控制病情，亦可加入標靶治療或免疫治療以控制病情
-
對於在胃食道交界的食道癌：
-
可以考慮使用標靶藥物或加入化療處理，亦可以採用免疫治療或免疫治療加化療進行治療
-
如果腫瘤屬HER2陽性，標靶治療加免疫治療合併化療可作為首選治療方案
食道癌的治療取決於多個因素，包括癌症的類型及分期、患者個人意願及健康狀況，以及治療副作用等。治療食道癌一般會混合不同治療方式，例如化療、放射治療、手術及免疫治療等等，並由結合不同專科醫生的跨專科團隊綜合意見後制定，以取得最佳效果。24
現在問，發現更多可能！向醫生了解不同療法的優點和可能副作用，一起制定最適合的治療方案。
常見問題
單一化療為傳統晚期食道癌的治療方法，患者的整體存活期少於1年。29 近年癌症治療不斷革新，其中免疫治療的面世更成為食道癌治療的新選擇，為晚期食道癌患者帶來更長的整體存活期。29,30
晚期食道鱗狀細胞癌患者使用一線免疫治療配合化療，有助提升治療效果。一項大型臨床研究顯示，在傳統化療當中加入免疫治療可延長整體存活期中位數。29
此外，免疫治療加化療的聯合治療能提升治療成功率，為患者帶來更顯著的治療反應，並有助延長無惡化存活期。29
跨專科治療是指由多個專科醫生/醫護人員組成的醫療團隊，與患者商討後共同決定治療方案及跟進，以確保患者能獲得優質的治療。31
研究指出，由於食道癌是最具侵略性的消化系統癌症，入侵性強且通常會影響患者的生活質素，治療的挑戰性相當高，需要透過跨專科治療和合作，以獲取最理想的治療效果。32,33
1. American Cancer Society. What is cancer of the esophagus? Available at: www.cancer.org/cancer/types/esophagus-cancer/about/what-is-cancer-of-the-esophagus.html. Accessed Sep 2024. 2. Cancer Research UK. What is oesophageal cancer? Available at: https://www.cancerresearchuk.org/about-cancer/oesophageal-cancer/about. Accessed Sep 2024. 3. Wang L, Du J, Sun H. Int J Public Health 2024;69:1607315. 4. Guts UK. Oesophageal cancer. Available at: gutscharity.org.uk/advice-and-information/conditions/oesophageal-cancer/. Accessed Sep 2024. 5. Sheikh M, et al. Cancers 2023;15:765. 6. Hong Kong Cancer Registry, Hospital Authority. Top Ten Cancers. Available at: www3.ha.org.hk/cancereg/topten.html. Accessed Sep 2024. 7. Huang FL, Yu SJ. Asian J Surg 2018;41:210-215. 8. Hong Kong Cancer Registry, Hospital Authority. Hong Kong cancer statistics: Incidence, male, board age group, 2013–2022, oesophagus, by year and age group. Available at: www3.ha.org.hk/cancereg/allagesresult.asp. Accessed Jan 2025. 9. Hong Kong Cancer Registry, Hospital Authority. Hong Kong cancer statistics: Incidence, female, board age group, 2013–2022, oesophagus, by year and age group. Available at: www3.ha.org.hk/cancereg/allagesresult.asp. Accessed Jan 2025. 10. Hong Kong Cancer Registry, Hospital Authority. Hong Kong cancer statistics: Mortality, both sexes, board age group, 2013–2022, oesophagus, by year and age group. Available at: www3.ha.org.hk/cancereg/allagesresult.asp. Accessed Jan 2025. 11. American Cancer Society. Esophageal cancer risk factors. Available at: www.cancer.org/cancer/types/esophagus-cancer/causes-risks-prevention/risk-factors.html. Accessed Sep 2024. 12. Cancer Research UK. Oesophageal cancer risk. Available at: www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/oesophageal-cancer/risk-factors. Accessed Sep 2024. 13. Conway E, Wu H, Tian L. Cancers 2023;15:5604. 14. Li J, et al. Chin J Cancer Res 2021;33:535-547. 15. American Cancer Society. Signs and symptoms of esophageal cancer. Available at: www.cancer.org/cancer/types/esophagus-cancer/detection-diagnosis-staging/signs-and-symptoms.html. Accessed Sep 2024. 16. Cancer Research UK. Symptoms of oesophageal cancer. Available at: www.cancerresearchuk.org/about-cancer/oesophageal-cancer/symptoms. Accessed Sep 2024. 17. HKSAR Government Cancer Online Resource Hub. Oesophageal cancer: Cancer facts. Available at: www.cancer.gov.hk/en/hong_kong_cancer/common_cancers_in_hong_kong/oesophageal_cancer.html. Accessed Sep 2024. 18. Cancer Research UK. Symptoms of advanced oesophageal cancer. Available at: www.cancerresearchuk.org/about-cancer/oesophageal-cancer/advanced-cancer/symptoms-advanced-cancer. Accessed Sep 2024. 19. American Cancer Society. Esophageal cancer stages. Available at: www.cancer.org/cancer/types/esophagus-cancer/detection-diagnosis-staging/staging.html. Accessed Sep 2024. 20. American Cancer Society. Tests for esophageal cancer. Available at: www.cancer.org/cancer/types/esophagus-cancer/detection-diagnosis-staging/how-diagnosed.html. Accessed Sep 2024. 21. Cancer Research UK. Tests for oesophageal cancer. Available at: www.cancerresearchuk.org/about-cancer/oesophageal-cancer/getting-diagnosed/tests-for-oesophageal-cancer. Accessed Sep 2024. 22. Dhakras P, et al. Transl Gastroenterol Hepatol 2020;5:55. 23. Wang X, et al. Front Immunol 2023;14:1117523. 24. Cancer Research UK. Treatment options for oesophageal cancer. Available at: www.cancerresearchuk.org/about-cancer/oesophageal-cancer/treatment/decisions-about-your-treatment. Accessed Sep 2024. 25. Puhr HC, Prager GW, Ilhan-Mutlu A. ESMO Open 2023;8:100789. 26. HUTCHMED. HUTCHMED Receives ELUNATE® (fruquintinib) Marketing Approval in Hong Kong for Treatment of Metastatic Colorectal Cancer.2024. 27. American Caner Society. Treating esophageal cancer by stage. Available at: www.cancer.org/cancer/types/esophagus-cancer/treating/by-stage.html. 28. He Y, Quaresma M, Dos-Santos-Silva I. Gastro Hep Adv 2022;2:426-437. 29. Gao TT et al. Comparative efcacy and safety of immunotherapy for patients with advanced or metastatic esophageal squamous cell carcinoma: a systematic review and network Meta-analysis. BMC Cancer. 2022;22(992):1-12. 30. American Cancer Society. Immunotherapy for esophageal cancer. Available at: www.cancer.org/cancer/types/esophagus-cancer/treating/immunotherapy.html. Accessed Sep 2024. 31. World Health Organization. Cancer treatment. Available at: www.who.int/europe/news-room/fact-sheets/item/cancer-treatment. Accessed Sep 2024. 32. Triantafyllou T,Wijnhoven B. Ann Gastroenterol Surg 2020;4:352-359. 33. Watanabe M, et al. Surg Today 2020;50:12-20.
#top_hero,#p1_index,#what_is_mob,#what_is,#Diagnostics_and_Biology_Marker_detection,#treatment_plan,#patient_support,#frequently_asked_question,#story,#references{
width:100%;
}
#what_is p,#frequently_asked_question p,.p2_tab_list li{
text-align:justify;
}
#what_is .col2_3_col p {
text-align:center;
}
@media all and (min-width: 1201px) {
.p2_sub_col1 div.mh-columns-inner div.mh-column div p,.p2_sub_col2 div.mh-columns-inner div.mh-column div p{
display: contents;
text-align: left;
}
figure.img_pie_chart {
width: 50%;
margin: auto;
}
.p2_sub_col1 div.mh-columns-inner div.mh-column{
width:50%;
margin:0px;
}
.p2_sub_col2 div.mh-columns-inner div.mh-column:nth-child(1){
width:100%;
margin:0px;
}
.p2_sub_col2 div.mh-columns-inner div.mh-column:nth-child(n + 2):nth-child(-n + 5){
width:50%;
margin:0px;
}
ul.p3_list_2 > li{
width: 100%;
}
col2_3_col_p {
max-width: 180px;
}
.story_col{
width: 380px;
}
.col_block{
min-height:220px;
}
.col2_3,.col3_2,.p3_tabs_tab,.p4_row,.p5_stack,.p4_tabs_tab,.p6_accordion {
padding:0 130px;
}
.col2_3, .col_block2 {
width:100%;
}
.hide_pc, div.hide_pc{
display:none;
}
}
@media all and (min-width: 576px) and (max-width: 1200px) {
.p2_sub_col1 div.mh-columns-inner div.mh-column:nth-child(n + 2):nth-child(-n + 5){
width:100%;
margin:0px;
}
.col2_3_col_p {
max-width: 180px;
}
.story_col{
width: 380px;
}
.col_block{
min-height:220px;
}
.col3_2{
padding:0 130px;
}
.col2_3,.p3_tabs_tab,.p6_accordion{
padding:0 30px;
}
.hide_pc, div.hide_pc{
display:none;
}
div.show_pc_flex{
display:flex;
}
.show_pc{
display:block;
}
}
@media all and (max-width: 767px){
ul.p3_list > li{
min-width: 110px;
}
ul.p3_list strong{
min-width: 70px;
text-align: left;
}
.p2_sub_col1 div.mh-columns-inner div.mh-column div,.p2_sub_col2 div.mh-columns-inner div.mh-column div{
padding:15px 0px;
}
.p2_sub_col1 div.mh-columns-inner div.mh-column,.p2_sub_col2 div.mh-columns-inner div.mh-column{
border-bottom:1px solid white;
padding-right: 0;
}
.p2_sub_col1 div.mh-columns-inner div.mh-column,.p2_sub_col2 div.mh-columns-inner div.mh-column{
width:100%;
margin:0px;
}
ul.mh-footer-menu li:nth-child(n + 6):nth-child(-n + 6){
float: left;
margin: 10px;
}
ul.mh-footer-menu li:nth-child(-n+5){
margin-bottom: 5px;
}
ul.mh-footer-menu li:nth-child(7){
float: right;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p2_list > li,[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p3_list_2 > li,[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p4_list > li{
margin-right: 0px;
}
ul.p3_list > li{
margin-right: 10px;
}
.p5_img{
display:none;
}
.p5_img_mob{
display:block;
transform: translate(0px, 66px);
}
.p5_img_mob2 {
padding-top: 30px;
margin-bottom: -65px;
}
}
@media all and (min-width: 768px){
ul.p3_list > li{
min-width: 110px;
}
ul.p3_list strong{
min-width: 80px;
text-align: left;
}
.p2_sub_col1 div.mh-columns-inner div.mh-column div,.p2_sub_col2 div.mh-columns-inner div.mh-column div{
padding-left: 25px;
padding-top: 10px;
padding-bottom: 10px;
}
.p2_sub_col1 div.mh-columns-inner div.mh-column div.is-content-justification-left,.p2_sub_col2 div.mh-columns-inner div.mh-column div.is-content-justification-left{
border-left:1px solid white;
border-bottom:1px solid white;
}
.p2_sub_col2 div.mh-columns-inner div.mh-column:nth-child(1){
width:100%;
margin:0px;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p3_list > li, [dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p2_list > li, [dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p4_list > li{
margin-right: 20px;
}
.p5_img{
max-width:300px;
transform: translate(0px, 100px);
z-index:1px;
}
.p5_img_mob{
display:none;
}
}
@media all and (max-width: 575px){
.p4_tabs_tab{
padding-bottom:30px;
}
.p2_sub_col1 div.mh-columns-inner div.mh-column,.p2_sub_col2 div.mh-columns-inner div.mh-column{
width:100%;
}
ul.mh-footer-menu li:nth-child(n + 6):nth-child(-n + 6){
float: left;
margin: 10px;
}
ul.mh-footer-menu li:nth-child(7){
float: right;
}
.col3_2 .mh-columns-inner .mh-column:nth-child(even){
margin-left: 10px;
margin-right: auto;
}.col3_2 .mh-columns-inner .mh-column:nth-child(odd){
margin-left: auto;
margin-right: 10px;
}
.story_col{
width: 100%;
}
.col3_2 div > figure > a > img{
max-width:100px;
}
.col3_2{
padding: 0 15px;
}
.tabs_tab .mh-tabs-nav, .p4_tabs_tab .mh-tabs-nav{
display: block;
}
.hide_pc{
display:block;
}
div.show_pc_flex{
display:none;
}
.show_pc{
display:none;
}
.p3_tabs_tab,.p5_stack{
padding:0 30px;
}
.col_block{
min-height:164px;
}
}
#mh_content{
margin:0px;
background: #FFFFFF
}
.p2line{
width:100%;
}
.title_line{
width:100%;
max-width:45px;
border-radius: 25px;
}
.footer_line{
width:100%;}
.p4_title_line{
width:100%;
max-width:30px;
}
.p5_bottom_img,.p5_bottom_img img{
width:100%;
z-index:2;
}
.top_img img, .top_img{
width:100%;
margin:0px;
}
.p2linedot{
width:100%;
max-width:35px;
border-radius: 25px;
margin-bottom:20px;
}
.p2_icon{
max-width:50px;
}
.p2_icon_block,.p3_tabs_sub_stack{
width:100%;
}
.tabs_tab a{
border-radius: 0px;
}
.p4_tabs_tab a{
height:40px;
}
.p4_tabs_tab a sup{
font-size: 50%;
top: -12px;
left: 10px;
margin-left: -10px;
}
.p2_col_checkbox{
width:100%;}
.tabs_tab,.p3_tabs_tab,.p4_tabs_tab,.p5_stack{
width:100%;
}
.p2_wp_block{
width:100%;
}
.p2_list_1 ul.p2_tab_list_1,ul.p3_list,ul.p3_list_2,ul.p6_list ,ul.p2_tabs_list,ul.p2_list,ul.p4_list{
margin-left:0px;
}
ul.p2_tab_list li{
margin-bottom: 5px;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p2_tab_list li::before{
background-color:#4C47A0;
}
.p2_list_1 ul.p2_tab_list_1,ul.p2_tab_list{
margin:0px;
}
.p2_list_1 ul.p2_tab_list_1{
margin-left:20px;
}
ul.p6_list, ul.p2_tab_list{
margin-top:0px;
}
ul.p3_list,ul.p6_list,ul.p2_tabs_list, ul.p2_list, ul.p4_list{
margin-bottom:0px;
}
ul.p3_list_2{
width:100%;
margin:0px;
text-indent: -1.625em;
padding-left: 25px;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p3_list_2 > li{
padding-left:0px;
margin-bottom: 0px;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p2_list > li{
padding-left:0px;
}
.p2_list_1{
width:100%;
}
.p2_list_1 ul.p2_tab_list_1 li{
padding-left: 15px;
margin-bottom: 0px;
}
.p2_list_1 ul.p2_tab_list_1 li::before,[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p2_tab_list_1 li::before{
height: 0.6em;
width: 0.6em;
border: 2px solid;
background-color: transparent;
color:#36BBCA;
}
.p2_list_1 ul.p2_tab_list_1 li ul li::before,[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p2_tab_list_1 li ul li::before{
height: 0.4em;
width: 0.4em;
border: 1px solid;
background-color: transparent;
}
.p2_tab_icon{
max-width:190px;
}
.tabs_radio,.tabs_radio2{
background: #E6EDFF;
}
.p2_5_sub_col{
width:100%;
}
.p2_5_sub_icon{
max-width:70px;}
.p2_5_icon{
min-width:150px;}
.p3_list li,.p6_list li,.p2_tabs_list li,.p2_list li,.p4_list li{
float: left;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p3_list > li,[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p4_list > li{
background: #FFFFFF;
padding: 1px 10px;
border-radius: 25px;
text-align: center;
}
ul.p4_list > li{
min-width: 160px;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p2_list > li{
background: #F6F7F7;
padding: 0 10px;
border-radius: 25px;
}
ul.p2_tabs_list > li{
background: white;
padding: 2px 12px;
border-radius: 12px;
color: #4C47A0;
word-break: keep-all;
}
ul.p6_list > li,ul.p2_tabs_list >li{
margin-right: 10px;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p2_tabs_list > li::before{
display:none;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p3_list > li::before,[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p6_list > li::before{
content: ‘\2713’;
display: inline-block;
position: relative;
top: 0px !important;
width: 18px;
height: 18px;
margin-right: 8px;
padding: 4px;
font-size: 12px;
font-weight: bold;
line-height: 11px;
border-radius: 50%;
text-align: center;
color: #FFF;
background: #4C47A0;
}
ul.p3_list strong{
margin: auto;
display: contents;
}
ul.p4_list {
margin: auto;
text-align: center;
}
ul.p2_list strong{
min-width: 110px;
margin: auto;
text-align: center;
}
ul.p6_list strong{
margin: auto;
display: inline-block;
text-align: center;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p2_list > li::before{
content: ‘\2713’;
display: inline-block;
position: relative;
top: 0px !important;
width: 18px;
height: 18px;
margin-right: 8px;
padding: 4px;
font-size: 12px;
font-weight: bold;
line-height: 11px;
border-radius: 50%;
text-align: center;
color: #FFF;
background: #4C47A0;
text-indent: 0em;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p3_list_2 > li::before{
content: ‘\2713’;
display: inline-block;
position: relative;
top: 0px !important;
width: 18px;
height: 18px;
margin-right: 8px;
padding: 4px;
font-size: 12px;
font-weight: bold;
line-height: 11px;
border-radius: 50%;
text-align: center;
color: #FFF;
background: #36BBCA;
text-indent: 0em;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p4_list > li::before{
content: ‘\2713’;
display: inline-block;
position: relative;
top: 0px !important;
width: 25px;
height: 25px;
margin-right: 12px;
padding: 8px;
font-size: 15px;
font-weight: bold;
line-height: 10px;
border-radius: 50%;
text-align: center;
color: #FFF;
background: #4C47A0;
text-indent: -2px;
}
.p4_stack{
width:100%;
}
.p4_arrow{
width:100%;
max-width:25px;
}
.p6_accordion section{
border-bottom:0px;
}
.p6_accordion section .mh-accordion-molecule-header{
background: #F0F0F0;
border-radius: 15px;
padding: 5px 20px;
margin-bottom: 10px;
}
.mh-accordion-molecule .mh-accordion-molecule-header__icon{
margin-right: 1.375rem;
max-height: 3.8125em;
max-width: 3.8125em;
}
#references{
word-break:break-all;
}
#references p{
text-align: justify;
margin-bottom: 15px;
}
#mh_header .mh-container{
min-height: 100px;
}
.mh-header–header-7 #mh_primary > ul > li > a{
padding-bottom: 0.15em;
padding-top: 0.15em;
max-height: 40px;
outline: none;
background: transparent;
}
li:has(.mh-megamenu–open){
color: #298C89;
border: 0.125rem solid;
border-radius: 25px;
padding: 0 0;
height: 40px;
}
#mh_primary ul.mh-submenu li:nth-child(1) a {
color: #005C55;
border: none;
padding:0px;
}
.mh-header–header-7 #mh_primary > ul > li > a{
padding-bottom: 0.15em;
padding-top: 0.15em;
max-height: 40px;
}
#mh_footer{
background:#FFF;}
div.mh-footer-note li:nth-child(1){
margin-right: auto;
}
#mh_footer > div.mh-footer-note > div > nav > ul.mh-footer-menu li:nth-child(2),ul.mh-footer-menu li:nth-child(7){
margin-left: auto;
}
.mh-footer-main-content{
max-width: 1200px;
margin: auto;
}
.mh-content__title{
display: none;
}
.mh-breadcrumb a,.mh-breadcrumb li{
color:#FFF;
}
.story_row_2{
width:100%;
}
.col2_3_col_p {
max-width: 180px;
text-align:left;
}
.p4_img,.p7_img{
max-width:350px;
width:100%;
}
.mh-breadcrumb–align-full{
display:none;}
.wp-block-table{
width: 100%;
overflow: auto;
}
.col2_3,.col_block2 div,.col_block2 div div{
width:100%;
}
.wp-block-table table{
text-align: center;
}
.wp-block-table.p2_table td:nth-child(2),.wp-block-table.p2_table td:nth-child(3){
min-width: 280px;
border-right: 1px solid white;
border-bottom: 1px solid white;
padding:0px;
width: 50%;
}
.wp-block-table.p2_table td:nth-child(1){
min-width: 150px;
border-right: 1px solid white;
border-bottom: 1px solid white;
padding:0px;
}
.wp-block-table.p2_table_2 tr:nth-child(2) td:nth-child(1),.wp-block-table.p2_table_2 tr:nth-child(1) td:nth-child(1){
min-width: 130px;
border-right: 1px solid white;
border-bottom: 1px solid white;
padding:0px;
}
.wp-block-table.p2_table_2 tr:nth-child(3) td:nth-child(2),
.wp-block-table.p2_table_2 tr:nth-child(4) td:nth-child(1),
.wp-block-table.p2_table_2 tr:nth-child(5) td:nth-child(2),
.wp-block-table.p2_table_2 tr:nth-child(7) td:nth-child(1),
.wp-block-table.p2_table_2 tr:nth-child(9) td:nth-child(2),
.wp-block-table.p2_table_2 tr:nth-child(11) td:nth-child(1),
.wp-block-table.p2_table_2 tr:nth-child(13) td:nth-child(1){
max-width: 50px;
border-right: 1px solid white;
border-bottom: 1px solid white;
padding:0px;
color:#315996;
}
.wp-block-table.p2_table_2 tr:nth-child(1) td:nth-child(2){
min-width: 460px;
border-right: 1px solid white;
border-bottom: 1px solid white;
padding:0px;
border-radius: 0px 15px 0 0;
}
.wp-block-table.p2_table_2 tr:nth-child(14) td:nth-child(4){
border-radius: 0px 0px 15px 0px;
}
.wp-block-table.p2_table_2 tr:nth-child(14) td:nth-child(1){
border-radius: 0px 0px 0px 15px;
}
.wp-block-table.p2_table_2 tr:nth-child(1) td:nth-child(2) ul{
margin:0px;
}
.wp-block-table.p2_table_2 tr:nth-child(2) td:nth-child(2),.wp-block-table.p2_table_2 tr:nth-child(2) td:nth-child(3){
min-width: 230px;
border-right: 1px solid white;
border-bottom: 1px solid white;
padding:0px;
}
.wp-block-table.p2_table_2 tr:nth-child(3) td:nth-child(1),
.wp-block-table.p2_table_2 tr:nth-child(5) td:nth-child(1),
.wp-block-table.p2_table_2 tr:nth-child(9) td:nth-child(1),
.wp-block-table.p2_table_2 tr:nth-child(14) td:nth-child(1){
min-width: 130px;
border-right: 1px solid white;
border-bottom: 1px solid white;
padding:0px;
}
.wp-block-table.p2_table_2 tr:nth-child(3) td:nth-child(3),
.wp-block-table.p2_table_2 tr:nth-child(4) td:nth-child(2),
.wp-block-table.p2_table_2 tr:nth-child(5) td:nth-child(3),
.wp-block-table.p2_table_2 tr:nth-child(6) td:nth-child(1),
.wp-block-table.p2_table_2 tr:nth-child(7) td:nth-child(2),
.wp-block-table.p2_table_2 tr:nth-child(8) td:nth-child(1),
.wp-block-table.p2_table_2 tr:nth-child(9) td:nth-child(3),
.wp-block-table.p2_table_2 tr:nth-child(10) td:nth-child(1),
.wp-block-table.p2_table_2 tr:nth-child(11) td:nth-child(2),
.wp-block-table.p2_table_2 tr:nth-child(12) td:nth-child(1),
.wp-block-table.p2_table_2 tr:nth-child(13) td:nth-child(2),
.wp-block-table.p2_table_2 tr:nth-child(14) td:nth-child(2){
min-width: 230px;
border-right: 1px solid white;
border-bottom: 1px solid white;
padding:0px;
color:#000;
}
.wp-block-table.p2_table_2 tr:nth-child(3) td:nth-child(4),
.wp-block-table.p2_table_2 tr:nth-child(4) td:nth-child(3),
.wp-block-table.p2_table_2 tr:nth-child(4) td:nth-child(3),
.wp-block-table.p2_table_2 tr:nth-child(5) td:nth-child(4),
.wp-block-table.p2_table_2 tr:nth-child(6) td:nth-child(2),
.wp-block-table.p2_table_2 tr:nth-child(7) td:nth-child(3),
.wp-block-table.p2_table_2 tr:nth-child(8) td:nth-child(2),
.wp-block-table.p2_table_2 tr:nth-child(9) td:nth-child(4),
.wp-block-table.p2_table_2 tr:nth-child(10) td:nth-child(2),
.wp-block-table.p2_table_2 tr:nth-child(11) td:nth-child(3),
.wp-block-table.p2_table_2 tr:nth-child(12) td:nth-child(2),
.wp-block-table.p2_table_2 tr:nth-child(13) td:nth-child(3),
.wp-block-table.p2_table_2 tr:nth-child(14) td:nth-child(3){
min-width: 230px;
border-right: 1px solid white;
border-bottom: 1px solid white;
padding:0px;
color:#000;
}
.wp-block-table thead,.wp-block-table thead th{
border-bottom: 0px solid;
}
.p2_table table tbody tr,.p2_table table tbody tr:nth-child(even),.p2_table_2 table tbody tr,.p2_table_2 table tbody tr:nth-child(even){
background-color:#FFF3FB;
}
.p2_table table thead th:nth-child(1){
background-color:#FFF3FB;
border-radius: 25px 25px 0 0;
padding-top: 10px;
}
.p2_table_2 table thead th:nth-child(1){
background-color:#FFF3FB;
border-radius: 10px 10px 0 0;
padding:5px 0px;
}
.p2_table_2 table thead th:nth-child(2){
width:0px;
}
.p2_table table thead th:nth-child(2),.p2_table table thead th:nth-child(3){
background-color:#F2F2F3;
border-radius: 25px 25px 0 0;
padding-top: 10px;
}
.p2_table table tbody td:nth-child(2),.p2_table table tbody td:nth-child(3){
color:#000;
font-weight: 700;
}
.p2_table table tbody td:nth-child(2) ul{
margin:0px;
display: inline-block;
width: 190px;
}
.p2_table table tbody td:nth-child(3) ul{
margin:0px;
display: inline-block;
width: 280px;
}
.p2_table ,.p2_table_2{
color:#4C47A0;
font-weight: 700;
}
.p2_table table tbody tr:nth-child(4) td:nth-child(1){
border-radius: 0px 0px 0px 25px;
}
.p2_table table tbody tr:nth-child(4) td:nth-child(3){
border-radius: 0px 0px 25px 0px;
}
.p2_sub_col1 div.mh-columns-inner div.mh-column,.p2_sub_col2 div.mh-columns-inner div.mh-column{
margin:0px;
}
.p4_list{
max-width:600px;
}
.plan_btn1{
width: 225px;
}
.support_btn1{
width: 240px;
}
.story_btn1{
width:225px;
}
.QA_btn1{
width:250px;
}
figure.lightning{
width:200px;
margin:auto;
}
[dir=ltr] ul.mh-v2-clist.mh-v2-clist–dot.p4_tab_list_1 li::before{
background-color:#4C47A0;
}
ul.p4_tab_list_1 li{
margin: 0;
}
ul.p4_tab_list_1 {
margin: 0px;
padding: 0px;
}
#what_is .pie_chart_text2{
width:100%;
text-align:right;
}
figure.img_pie_chart_line1 {
width: 30%;
margin-top: -16%;
margin-left: 50%;
margin-bottom: -3%;
}
figure.img_pie_chart_line2 {
width: 10%;
margin-top: -4%;
margin-left: 35%;
margin-bottom: -10%;
z-index: 1;
}
.w100{
width:100%;
}
#mconnect-theme-banner-container-4373 > div > div > div > div > div.banner__content.sub__entry__content > div > a,#mh_back_to_top_link > a,.cta_btn {
background-color:#4C47A0;
border: 1px #FFF solid;
}
sup{
white-space: pre;
}
.mh-nav-side-accordion ul li{
margin: 20px 0;
}
.mh-nav–primary li:hover{
color: #298C89;
border-bottom: 0.125rem solid;
padding: 0 0;
height: 40px;
}
.mh-nav–primary .mh-submenu li:hover{
color: #298C89;
border: none;
padding: 0 0;
height: 40px;
}
.footer_code::before {
content: “HK-KEY-00958 Mar/2025”;
color:#000;
}
