食管小细胞癌伴高分化鳞癌的病理研究  

Clinicopathologic study on the small cell carcinoma accomphnild with wen differentiated squamous cell carcinoma of the esophagus

作　　者：杨清绪[1] 云径平[2] 侯景辉[2] 

机构地区：[1]广东省惠州市中心医院病理科,惠州516001 [2]中山医科大学肿瘤防治中心病理科,广州510060

出　　处：《癌症》1999年第2期159-161,共3页Chinese Journal of Cancer

摘　　要：目的：探讨原发性食管小细胞癌伴高分化磷癌的临床病理特点及发生机理。方法：我们收集6例食管小细胞癌伴高分化鳞癌的手术病例进行统计分析。每例做常规染色并采用LSAB法做免疫组化。结果：病灶部位在食管中下段。淋巴结转移6例（100％），合并血道转移5例（83．3％）。本组病例肉眼形态为溃疡型（4例）和息肉型（2例）。镜下观察每例肿瘤均由小细胞癌及高分化鳞癌组成，其中小细胞癌可分为燕麦细胞样小细胞癌（3例）和非燕麦细胞样小细胞癌（3例）。两种肿瘤成分未见移行关系，而高分化鳞癌成分与正常鳞状上皮之间有移行关系。免疫组化显示小细胞癌成分铬粒素（chromograninA，CgA）6例阳性（100％），神经烯醇化酶（NSE）6例阳性（100％）。S－100，白细胞共同抗原（LCA）、细胞角蛋白（CK）均呈阴性，而高分化鳞癌成分CK均呈阳性。结论：食管小细胞癌伴高分化鳞癌是同一肿瘤病灶出现两种不同分化形态及不同免疫表型，而临床上类似食管小细胞癌和起源于食道粘膜上皮恶性程度高的肿瘤，其发生机理有待深入研究。Purposes: To study the clinicopathologic features of the small cell carcinomas with well － diffirentiated squamous cell carcinomas of the esophagus and detect the genesis of this tumor. Methods: 6 operated cases of this tumors were examined and analysed. These cases were also observed by way of special stain such as argentaffin stain and immunohistochenial stain such as LsAB methods. Results: The sites lie in both the middle part and the lower of the esophagus. The clinical features included early metastases. The two different morphodifferentiations－ small c ell careinomas (SCC ) and well differentiated squamous cell carcinomas(WDS) were detected in 6 cases Immunohistochemical results showed CgA and NSE were all pettive as 6/6(100% ) in the part of SCC. However LCA, CK and S－100 were negetive in SCC. CK were all strong positive in WDS, and the others were negative. Conclusions: SCC. with WDS in 6 cases were two different morphodifferentiations and different immunolabelings in one tumor lesion and clinicaly itis simular to small cell careinoma of esophagur and high－malignant tumor rised from esophageae mucosae epitteliuns with. The genesis of these tumors need further investigation.

关 键 词：食管肿瘤 小细胞癌 高分化鳞癌 病理学 

分 类 号：R735.102[医药卫生—肿瘤]