同时性多原发食管癌  

The clinical analysis of the synchronous multiple primary esophageal carcinoma

作　　者：于涛[1] 李建业[1] 蒋俭[1] 张云峰[1] 李飞[1] 余震[1] 柯冀[1] 

机构地区：[1]首都医科大学附属北京同仁医院胸外科,100730

出　　处：《中华胸心血管外科杂志》2011年第10期604-606,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨同时性多原发食管癌的临床特点、诊断和治疗。方法采用回顾性研究的方法，对收治的32例同时性多原发食管癌的临床资料进行总结、分析。结果全组食管双原发灶30例，三原发灶2例，共66个病灶，其中位于颈段22个，胸上段10个，胸中段19个，胸下段15个。66个病灶中，鳞癌65个，腺癌1个。32例中术前确诊26例。32例均采用手术治疗，其中4例行探查手术，1例行姑息切除手术，余27例行完全性切除手术。术后病理食管残端阳性2例。术后出现并发症8例。术后随访28例，1、3和5年生存率分别为76．9％、43．3％和14．8％。结论完善的术前检查可显著提高同时性多原发食管癌的确诊率，手术是其较好治疗方法。Objective To investigate the clinical characteristics, the diagnosis and therapy of synchronous multiple primary esophageal carcinoma. Methods Thirty-two cases of synchronous multiple primary esophageal carcinoma were collected from January 1980 to December 2010 and their clinic data were retrospectively analysised. Results In the whole group, there were totally 66 lesions in 30 cases of double primary lesion and 2 cases of three primary lesion. The length of the lesions were lcm to 6.5 cm, and there were 22 lesions in cervical esophagus, 10 in upper thoracic esophagus, 19 in midthoracic esophagus and 15 in lower thoracic esophagus. Within the 66 lesions, 65 lesions were squamous cell carcinoma and 1 was adenocarcinoma. The mucosa between the lesions were normal, with a distance of 4 cm to 9.5 cm, average 7. 1 cm. Thirty-two patients with synchronous multiple .primary esophageal carcinoma received surgery. Among 32 cases, 26 of them were given definite diagnosis before operation. Four of them had exploratory operation, one patient underwent palliative resection, 27 patients underwent radical resection. Two cases of the pathologic results of esophageal stump showed carcinoma after operation. The complications occurred in 8 patients. Twenty-eight cases were followed up after operation, the 1, 3 and 5-survival rate were 76.9% , 43.3 and 14.8 % , respectively. Conclusion General pre-operation examination can significant helpful for the definite diagnosis of synchronous multiple primary esophageal carcinoma and surgical treatment is better choice for this disease.

关 键 词：食管肿瘤 肿瘤 多原发性 胸外科手术 

分 类 号：R735.1[医药卫生—肿瘤]