5406 例不同类型食管肿瘤临床病理特征对比分析

 目的 探讨小细胞癌、癌肉瘤等少见食管肿瘤以及小年龄组食管肿瘤的临床病理特征。方法 回顾性分析5406例食管肿瘤术后的病理诊断结果，观察各种肿瘤的早诊率、淋巴结转移率及年龄分布情况，对比分析所见各种食管肿瘤的特点。结果 5406例中29例双原癌（同时合并贲门腺癌）；5377例均为单发食管肿瘤，其中鳞癌95．5％，腺鳞癌1．8％，腺癌0．5％，其他类型4％。全部病例中早诊率为9．1％，淋巴结转移率为39．6％。各型早诊率和淋巴结转移率之间差异无显著性（χ²=7．384，12．677；P=0．597，0．178）。小细胞癌与鳞癌的淋巴结转移率之间差异有显著性（χ²=4．704，P=0．030）。小年龄组（≤40岁）与其他年龄组比较，两组间早诊率及淋巴结转移率差异均无显著性（x^2=0．186，0．558；P=0．666，0．455）。结论 食管胸中段是各型肿瘤的好发部位。食管肿瘤以鳞癌最多，腺鳞癌次之，其次为小细胞癌、腺癌及癌肉瘤等。各型肿瘤的早诊率及淋巴结转移率均相似，仅小细胞癌淋巴结转移率明显高于鳞癌。各年龄段食管肿瘤早诊率及淋巴结转移率无统计学差异。提高食管肿瘤的早诊率是亟待解决的问题。

Analysis of Clinicopathological Characteristics for Different Histological Type of Esophageal Neoplasm

Objective 　To explore the clinicopathological characteristics for different histological type of esophageal neoplasms ( EN) . Methods 　To observe the rate of each typical ENs’s early stages ( ES) , the rate of lymph node metastasis (LNM) ,and feature of it s distribution ,5 406 patients with ENs were ret rospectively reviewed. Results 　Twenty-nine patients were concurrent cancer ,other patients suffered from single esophagueal disease. The rate of squamous carcinoma ,adeno-squamous carcinoma and adenocarcinoma was 95. 5 % ,1. 8 % and 0. 5 % , respectively , the others was 4 %. The rates of ES and LNM were 9. 1 % and 39. 6 %. The difference of the rate of ES and LNM between each type was not significant (χ² =7. 384 ,12. 677 ; P = 0. 597 ,0. 178) . But the rate of LNM was significant different between small cell carcinoma and squamous carcinoma ( P < 0. 05) . Conclusion 　Most of EN were found in middle segment ,squamous carcinoma was absolute major EN ,the following was adeno-squamous carcinoma ,small cell carcinoma ,adeno-carcinoma and carcinosarcoma. The rate of LNM of small cell carcinoma was significant different from squamous carcinoma’s. The rate of ENs and LNM in each age’s had no significant difference.