食管癌肉瘤的诊断与治疗

目的 总结食管癌肉瘤的临床、病理学特点，探讨其诊断、治疗。方法 回顾性研究27例食管癌肉瘤的临床资料及治疗结果。结果 食管癌肉瘤呈息肉型或浸润型生长，以息肉型居多，一般不向食管壁周围组织浸润。本组27例无1例外侵，手术切除率100％，其中根治性切除26例，淋巴结转移率11．1％。无1例手术死亡。术后1、3年生存率分别为96．3％和88．9％。结论 食管癌肉瘤是一种以腔内生长为主，侵袭性差，淋巴结转移率低，手术切除预后较佳的肿瘤。组织来源可能为食管多潜能干细胞。

Diagnosis and treatment of esophageal carcinosarcoma

Objective To explore the diagnosis an treatment of esophageal carcinosarcoma and its histogenesis according to its clinical and pathological characteristics. Methods Clinical data and therapeutic effects of 27 patients with esophageal carcinosarcoma were studied retrospectively. Results The esophageal carinosarcoma grew in polyp or infiltration, mainly polyp. It often connected the wall of esophagus with pedicle. The tumor was generally confined to the wall of esophagus and most of cases were in early stage. In this group including 27 cases, none belonged to the invasive tumor, and the rate of lymph node metastasis and surgical resection was 11.1% and 100 % respectively. The mortality was zero. The survival rate of 1- and 3-years after operation was 96.3 % and 88.9 % respectively. Conclusion Esophageal carcinosarcoma is an independent entity with accelerated intraluminal growth, little invasiveness, low lymph node metastasis and better prognosis after surgery. Both squamous cell carcinoma and sarcoma cells might originated from a pluripotent stem cell.