摘要
目的总结早期食管癌内镜及病理特点，探讨其对临床诊断的价值。方法回顾性分析2003年1月至2007年12月西南医院收治的62例早期食管癌患者的临床资料，总结其内镜和病理特点。结果食管上段癌8例，中段癌42例，下段癌12例。内镜分型依次为表面扩散生长型30例，双向生长型11例，腔内生长型9例，壁内生长型7例，混合生长型5例。多数肿瘤直径为1．0～2．9cm。行外科手术治疗38例、内镜黏膜切除术治疗23例、内镜黏膜下层剥离术治疗1例。术后病理检查：原位癌13例，黏膜内癌22例，黏膜下癌27例，黏膜内癌和黏膜下癌的淋巴结转移率分别为5％（1／22）和15％（4／27）。病理分型：鳞癌57例，腺癌2例，小细胞癌、肉瘤化癌、梭形细胞癌各1例。结论早期食管癌好发于食管中段，以表面扩散生长型多见，以鳞癌为主，普通内镜联合卢戈液和美蓝检查是发现早期食管癌的重要方法。
Objective To analyze and investigate endoscopic and pathological characteristics in the diagnosis of early esophageal carcinoma. Methods The clinical data of 62 patients with early esophageal carcinoma who had been admitted to Southwest Hospital from January 2003 to December 2007 were retrospectively analyzed. Results Of all patients, 8 had upper esophageal carcinoma, 42 had middle esophageal carcinoma and 12 had lower esophageal carcinoma. The tumor growth patterns included surface diffusion growth （ n = 30） , bidirectional growth （ n = 11 ）, intraeavitary growth （ n = 9 ）, intra-esophageal wall growth （ n = 7 ） and mixed growth （ n = 5 ）. The diameter of lesions ranged from 1.0 cm to 2.9 em in majority. Surgical resection was done in 38 patients, endoscopic mucosal resection in 23 patients and endoscopic submueosal dissection in 1 patient. Postoperative pathological examination showed that 13 patients had in situ carcinoma, 22 had intramueosal carcinoma and 27 had submueosal carcinoma. The lymph node metastatic rate of intramueosal carcinoma and submucosal carcinoma were 5% （1/22） and 15% （4/27）, respectively. The numbers of squamous cell carcinoma, adenocarcinoma, small cell carcinoma, sarcoma carcinoma and spindle carcinoma were 57, 2, 1, 1, 1, respectively. Conclusions Early esophageal carcinoma tends to appear in the middle part of esophagus, and with surface diffusion growth type. Most of the early esophageal carcinoma are squamous cell carcinoma. Endoscopy combined with lugol＇s iodine and methyleneblue staining is effective in detecting early esophageal carcinoma.
出处
《中华消化外科杂志》
CAS
CSCD
2009年第2期144-146,共3页
Chinese Journal of Digestive Surgery
基金
重庆市科技攻关计划项目（2008AC5003）
关键词
食管肿瘤
内镜
病理特点
Esophageal neoplasms
Endoseopes
Pathological features
