原发性食管小细胞癌28例临床特征及预后分析

目的 探讨可切除原发性食管小细胞癌(primary esophageal small cell carcinoma,PESCC)的临床特征及预后影响因素.方法 分析28例PESCC患者的临床资料,分析影响预后的相关因素.结果 PESCC占同期手术切除食管恶性肿瘤患者的1.3%,男20例,女8例.总的1、2、3年生存率分别为67%、32%、14%,中位生存时间为19个月;N0组的3年生存率明显高于N1组,两组差异统计学意义( P <0.01).肝脏为该组患者的常见转移部位;单因素分析显示肿瘤长度、肿瘤浸润程度、血清CEA水平升高、淋巴结是否转移为预后影响因素.多因素分析结果表明肿瘤浸润程度、淋巴结是否转移为影响预后的独立因素.结论 PESCC临床少见,预后差,肿瘤浸润程度、淋巴结是否转移是影响PESCC患者预后的危险因素.

Clinical features and prognosis in patients with primary esophageal small cell carcinoma:a report of 28 cases

Objective To explore the clinical features and prognosis in patients with primary esophageal small cell carcinoma (PESCC). Methods Data of 28 patients with operable PESCC,treated in Shantou Central Hosptal from Jan. 2000 to Dec.2008 were reviewed. Pearson x2 test was performed for frequencies comparison. Survival rate was analyzed by Kaplan-Meier method and compared by Log-rank test. The Prognostic factors were analyzed using Cox regression model. Results These patients represented 1.3% of all esophageal malignancies diagnosed during this period. 20 cases were male and 8 were female. The 1-,2- and 3- year overall survival rates were 67%,32% and 14%,respectively. The overall median survival time was 19 months. There was a significantly higher 3-year overall survival rate for patients with N0 subgroup compared with N1 subgroup ( P <0.01). The distant metastases in these PESCC patients tended to occur in liver frequently. Univariate analysis revealed that the prognostic predictors included length of the primary lesion,the invasion depth,lymph nodes metastasis and high blood CEA level. Multivariate analysis revealed both the invasion depth and lymph nodes metastasis were independent prognostic factors. Conclusion Primary small-cell carcinoma of the esophagus is rare and has a poor prognosis. The invasion depth and lymph nodes metastasis are independent prognostic factors.