INTRAMURAL METASTASIS OF THORACIC ESOPHAGEAL-CARCINOMA
INTRAMURAL METASTASIS OF THORACIC ESOPHAGEAL-CARCINOMA
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DOI：
10.1002/ijc.2910500111
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发表时间：
1992-01-02
影响因子：
6.4
通讯作者：
ISHIKAWA, T
中科院分区：
文献类型：
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作者：
KATO, H;TACHIMORI, Y;ISHIKAWA, T
在393例胸段食管鳞状细胞癌患者中，60例经组织学检查发现有壁内转移。其中50例经肉眼检查发现转移灶。似乎没有首选原发性病变近端的位置。18例有胃壁转移，提示食管壁与胃壁之间存在淋巴通道。所有60例原发性肿瘤均侵犯粘膜下层。将60例患者（A组）与一组匹配的无壁内转移的对照患者（B组）进行比较。A组肿瘤体积明显大于B组（p < 0.01）。A组淋巴结转移例数明显高于B组（P < 0.01），平均阳性淋巴结数明显高于B组（P < 0.01）。纵隔淋巴结和肝脏的复发性疾病是A组的特征。A组患者的生存曲线明显低于B组（p < 0.001）。术后常规放疗或化疗均不能改善预后。这些结果表明，在评估食管鳞状细胞癌患者的预后时，壁内转移的存在是一个重要的考虑因素。
Of 393 patients with squamous-cell carcinoma in the thoracic esophagus, 60 were found by histologic examination to have intramural metastasis. Metastases in 50 of these were identified by gross inspection. There appeared to be no preference for location proximal to the primary lesion. Eighteen patients had metastasis to the gastric wall, which suggested the existence of communicating lymphatic channels between the wall of the esophagus and the stomach. All 60 primary tumors invaded beyond the submucosa. These 60 patients (group A) were compared with a group of matched control patients without intramural metastasis (group B). The tumor size in group A was significantly larger than in group B (p < 0.01). The number of patients with lymph-node metastasis was significantly higher in group A (p < 0.01), and the average number of positive nodes in group A was greater than in group B (p < 0.01). Recurrent disease in the mediastinal lymph nodes and in the liver is characteristic of group A. The survival curve for patients in group A was significantly lower than that for group B (p < 0.001). Conventional radiotherapy or chemotherapy after surgery were ineffective in improving prognosis. These results indicate that the presence of intramural metastasis is an important factor to consider when evaluating the prognosis of patients with squamous-cell carcinoma of the esophagus.