86例早期食管癌临床诊治探讨  

Clinical Analysis of 86 Cases of Early Esophageal Carcinoma

作　　者：许建华[1] 郑正荣[1] 许双塔[1] 叶凯[1] 

机构地区：[1]福建医科大学附属第二医院肿瘤科,福建省泉州市362000

出　　处：《中国肿瘤临床》2008年第10期547-550,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨提高早期食管癌的诊断率和远期生存率的体会。方法:对福建医科大学附属第二医院自1998年1月至2004年12月手术治疗的86例早期食管癌进行回顾性分析。结果:本组病例部分早期食管癌症状大多轻微,自觉不适病程长短不一,X线检出率为84.9%(73/86),电子胃镜检查确诊率为100%(86/86)(其中尚有1例经过3次镜检获得病理诊断)。手术切除率为100%(86/86),并发症发生率为14.0%(12/86)。术后均未再行辅助治疗,定期随访,5年生存率为94.2%(81/86)。结论:早期食管癌的病程进展比较缓慢,症状轻微,呈非特异性,容易忽视,应高度重视早期食管癌的症状,采用内镜结合碘染色等检查方法多次检查(必要时采用多项检查方法和定期复查),结合临床症状综合分析,将有助于提高早期食管癌的诊断率。一些分子生物学指标被用于食管癌的实验室诊断,亦将有助于提高早期食管癌的诊断。早期食管癌的手术治疗远期疗效佳,手术治疗(食管次全切除并常规区域淋巴结清扫)是治疗早期食管癌的有效方法。术后复发与转移是早期食管癌患者术后死亡的主要原因。早期食管癌手术治疗不能完全达到治愈目的,且术后患者生存期较长,应定期密切随访,以便尽早对食管复发癌或转移癌进行有效的治疗,提高患者的生存质量和远期生存率。Objective：To investigate the diagnosis rate and survival rate of early esophageal careinoma. Methods： We retrospectively reviewed 86 cases of early esophageal carcinoma seen in our hospital between 1998 and 2004. Results： Seventy-three cases were identified by X-ray and all 86 cases were given a definitive diagnosis with esophagofiberoscopy. The diagnosis rate of electronic gastroscopy was 100% （86/86）. The tumor resection rate was 100% （86/86） with a complication rate of 13.9% （12/86）. No auxiliary treatment was administered. The 5-year survival rate was 94.2%. Conclusion： Symptoms of early esophageal carcinoma may be slight and non-specific and have a slow progression. Molecular biological targets can be used for laboratory diagnosis of esophageal cancer. Surgery consisting of inferior total excision and conventional regional lymph node cleaning is the preferred method of treatment lor early esophageal carcinoma. Early diagnosis is crucial for maintaining a high survival rate. Postoperative recurrence and metastasis are the major causes of death after surgery. Surgical removal may increase survival time, but surgery alone cannot completely cure these patients and regular follow-up is necessary for the improvement of patient survival.

关 键 词：食管癌 诊断 外科治疗 

分 类 号：R735.1[医药卫生—肿瘤] R155.3[医药卫生—临床医学]