局限期原发性食管小细胞癌42例临床分析  

Clinical analysis of 42 cases with limited stage primary esophageal small cell carcinoma

作　　者：陈少斌[1] 杨捷生[1] 杨卫平[1] 翁鸿锐[1] 李桦[1] 刘迪填[1] 陈于平[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院外科,515000

出　　处：《肿瘤研究与临床》2011年第12期822-824,共3页Cancer Research and Clinic

摘　　要：目的分析局限期原发性食管小细胞癌（PESC）的临床特点及其诊断、治疗及预后。方法回顾性分析1990年11月至2010年12月汕头大学医学院附属肿瘤医院收治的以手术为主治疗的局限期PESC患者42例临床资料，采用Kaplan—Meier法进行生存分析。结果PESC的临床症状、影像学表现和内窥镜下表现与食管鳞状细胞癌相似。26例患者术前行胃镜活组织检查，5例病理诊断为小细胞癌，21例误诊为鳞状细胞癌。全组患者随访0—123个月，平均随访25．3个月，34例死亡，7例生存，1例失访。中位生存时间13．0个月（95％可信区间6．3～19．7个月）。0．5、1、2、3、5年生存率分别为78．6％、57．5％、30．8％、23．7％、10．5％。结论PESC罕见，胃镜活组织检查病理易误诊，治疗效果差，目前尚无标准治疗模式。Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of limited stage primary esophageal small cell carcinoma.（PESC）. Methods Clinical data was retrospectively analyzed for 42 patients with pathologically confirmed PESCs who underwent transthoracic esophagectomy with lymphadenectomy from Nov. 1990 to Dec. 2010 at the Cancer Hospital of Shantou University Medical College. The survival analysis was performed using Kaplan-Meier method. Results The clinical symptoms, imaging and endoscopic features of PESC were similar to those of esophageal squamous cell carcinoma （ESCC）. Of the 26 cases that received pre-operative endoscopic biopsy, only five cases were diagnosed as PESC, while the other 21 cases were misdiagnosed as ESCC. The mean follow-up time of this series was 25.3 months （0- 123 months）. 34 patients died of the disease during the follow-up; 7 were still alive and 1 was lost. The median survival time （MST） of the 41 patients was 13.0 months （95 % confidence interval 6.3-19.7）, and the 6-, 12-, 24-, 36-, and 60-month overall survival rates （OS） were 78.6 %, 57.5 %, 30.8 %, 23.7 %, 10.5 %, respectively. Conclusion PESC is a rare disease with poor prognosis, and is prone to be misdiagnosed by endoscopic biopsy. Currently no standard treatment has been established.

关 键 词：食管肿瘤 癌 小细胞 治疗 预后 

分 类 号：R735.1[医药卫生—肿瘤]