食管黏液表皮样癌36例临床分析  

Clinical analysis of 36 cases of esophageal mucoepidermoid 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：《中华肿瘤杂志》2012年第3期232-235,共4页Chinese Journal of Oncology

摘　　要：目的总结食管黏液表皮样癌（MEC）的临床特点、诊断、治疗和预后。方法回顾性分析1991年1月至2010年6月间汕头大学医学院附属肿瘤医院收治的以手术治疗为主的36例食管MEC患者的临床资料，采用Kaplan—Meier法进行生存分析。结果36例食管MEC患者的临床症状、影像学表现和胃镜下所见与食管鳞癌相似，20例患者术前行胃镜检查，其中18例活检病理误诊为食管鳞癌，2例误诊为腺鳞癌。单纯手术治疗26例，手术加放疗10例。全组患者的中位生存时间为29．0个月，1、2、3和5年生存率分别为80．6％、57．1％、34．4％和25．8％。结论食管MEC罕见，胃镜活检病理易误诊，预后差，手术切除是目前最主要的治疗手段。Objective To review the clinical characteristics, diagnosis, treatment and prognosis of esophageal mucoepidermoid carcinoma （MEC）. Methods Clinical data of 36 patients with pathologically confirmed esophageal MEC who received surgical treatment in Cancer Hospital of Shantou University Medical College from Jan 1991 to Jun 2010 were retrospectively analyzed. The survival analysis was performed using Kaplan-Meier method. Results Of the 4253 patients diagnosed as esophageal cancer during the same time in our center, only 36 had esophageal MEC, accounted for 0.8%. This group included 27 men and 9 women ranging in age from 40 to 78 years （median 58 years）. Esophageal MEC showed similar clinical symptoms, radiological and endoscopic features to esophageal squamous cell carcinoma （ESCC）. Of the 20 cases who received preoperatively endoscopic biopsy, 18 were misdiagnosed as ESCC and 2 were misdiagnosed as esophageal adenosquamous carcinoma. The mean follow-up duration of this series was 38.8 months （3-142 months）. 22 patients died of the disease during the follow-up period, 12 were still alive and 2 were lost of follow-up. The median survival time （MST） of the 36 patients was 29.0 months, and the 1-, 2-, 3-, and 5-year overall survival rates （OS） were 80. 6%, 57. 1%, 34.4%, 25.8%, respectively. Conclusions Esophageal MEC is a rare disease and prone to be misdiagnosed by endoscopic biopsy. Surgical resection is the primary treatment but the prognosis is poor.

关 键 词：食管肿瘤 黏液表皮样癌 诊断 治疗 外科 预后 

分 类 号：R735.1[医药卫生—肿瘤]