Clinicopathological features of superficial squamous cell carcinoma of the esophagus
Clinicopathological features of superficial squamous cell carcinoma of the esophagus
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DOI：
10.1016/s0002-9610(97)00046-9
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发表时间：
1997-07-01
影响因子：
3
通讯作者：
Nagasue, N
中科院分区：
文献类型：
--
作者：
Tachibana, M;Yoshimura, H;Nagasue, N
背景：食管癌浸润深度是决定患者预后的关键因素。浅表性食管癌患者的临床病程明显优于晚期食管癌患者。粘膜癌患者的结局非常好，5年生存率超过80%。另一方面，粘膜下癌常转移至淋巴结或其他器官，这类患者的预后并不令人满意。1979年12月至1995年4月手术切除的165例食管鳞状细胞癌中，（18.2%）有局限于上皮、粘膜固有层或粘膜下层的浅表性食管癌（SEC）。结果：SEC的发病率从1979 ~ 1984年的6.3%（2/32）上升到1991 ~ 1995年的27.4%（20/73）。15例粘膜癌中2例（13.3%）和15例粘膜下癌中4例（26.7%）出现主观症状。其余24例（80%）患者无自觉症状。22例患者（73.3%）在筛查胃部问题时通过内镜检查诊断为病变，只有3例通过胃肠系列检查发现。15例粘膜癌患者均无淋巴管侵犯、静脉侵犯或淋巴结转移。另一方面，在粘膜下癌中，9例（60%）有淋巴管浸润，5例（33.3%）有静脉浸润，8例（53.3%）有淋巴结转移。22例患者存活，无复发。粘膜癌的3年和5年生存率分别为86.7%和86.7%，粘膜下癌的3年和5年生存率分别为72.2%和65.0%。(C)1997年，Excerpta Medica，Inc.
BACKGROUND: The depth of penetration is the crucial factor determining the prognosis of esophageal carcinoma patients. Patients with superficial esophageal carcinoma have a significantly favorable clinical course compared with those with advanced cancers. The outcome for patients with mucosal cancer is excellent with a 5-year survival rate exceeding 80%. On the other hand, submucosal cancer often metastasizes to lymph nodes or other organs, and the prognosis of these patients is far from satisfactory.METHODS: Among 165 patients with squamous cell carcinoma of the esophagus, surgically resected between December 1979 and April 1995, 30 patients (18.2%) had superficial esophageal carcinoma (SEC) confined to the epithelium, lamina propria mucosa, or submucosa. Disease profile and clinicopathological characteristics of these 30 patients were studied.RESULTS: The incidence of SEC has increased from 6.3% (2 of 32) in the first 5-year period (1979 to 1984) to 27.4% (20 of 73) in the recent 5-year period (1991 to 1995). Subjective symptoms were present in 2 (13.3%) with 15 mucosal cancers and in 4 (26.7%) with 15 submucosal cancers. The remaining 24 patients (80%) had no subjective symptoms. Twenty-two patients (73.3%) were diagnosed to have the lesions by endoscopic examination at the time of screening for gastric problems, and only 3 were detected by gastrointestinal series. None of the 15 patients with mucosal cancer had lymphatic invasion, venous invasion, or lymph node metastasis. On the other hand, in those with submucosal cancers, 9 (60%) had lymphatic invasion, 5 (33.3%) venous invasion, and 8 (53.3%) lymph node metastases. Twenty-two patients are alive without recurrence. The 3- and 5-year survival rates are 86.7% and 86.7% for patients with mucosal cancer and 72.2% and 65.0% for those with submucosal cancer, respectively.CONCLUSION: Esophagectomy with wide lymphadenectomy should be carried out for submucosal cancer, whereas esophagectomy with moderate lymphadenectomy can be preferred for mucosal cancer. (C) 1997 by Excerpta Medica, Inc.