食管癌内镜分型的临床意义

根据日本食管疾病学会制定的内镜分型标准，研究１７３例食管癌。检出６例浅表型（０型）癌，１６７例进展期癌。０型癌均经手术切除。在进展期癌中，Ⅰ型３３例（１９．１％），Ⅱ型２０例（１１．６％），Ⅲ型６４例（３６．９％），Ⅳ型３５例（２０．２％），Ⅴ型１５例（８．７％）。活检阳性率和手术切除率分别为９０．１％和８０．９％，Ⅰ型的活检阳性率和手术切除率明显高于Ⅳ型（Ｐ＜０．０５），表明新分型标准能客观反映病情预后，对临床有指导意义。

CLINICAL SIGNIFICANCE OF ENDOSCOPIC CLASSFICATION IN ESOPHAGEAL CANCER

Using the endoscopic classification system of the Japanese Society for Esophageal Disease,we studied 173 cases with esophageal cancer, including 6 superficial and 167 advanced tumors. Among advanced tumors,there were 33 protruding type (19.1%), 20 ulcerative and localized type (11. 6%), 64 ulcerative and infiltrative type (36. 9%), 35 diffusely infiltrative type (20. 2%) and 15 miscellaneous type (8.7%). The positive rate of biopsy and the resectability rate were 90.1% and 80.9% respectively.Compared with diffusely infiltrative type,a significant high positive rate of biopsy as well as resectabiility rate was observed in protruding type(P<0. 05%). We think that the JSED scheme is a reliable means to estimating the prognosis and deciding on appropriate treatment in esophageal cancer.