51例食管基底细胞样鳞癌外科治疗及预后分析  

Analysis of surgical treatment and prognosis of 51 cases of basaloid squamous cell carcinoma of the esophagus

作　　者：赵亮[1] 张百华[1] 高树庚[1] 薛奇[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院胸外科,北京100021

出　　处：《癌症进展》2015年第1期91-95,共5页Oncology Progress

摘　　要：目的食管基底细胞样鳞癌(basaloid squamous cell carcinoma of the esophagus,BSCCE)是一类少见的具有独特病理特征的鳞癌亚型,本研究旨在探讨BSCCE的临床特征及预后。方法回顾性分析经手术和病理证实的51例BSCCE患者的临床资料,并与同期手术的食管低分化鳞癌患者进行生存比较。结果 51例BSCCE患者,包括Ⅰ期5例,Ⅱ期28例,Ⅲ期18例。其中35例患者接受胃镜检查,仅有4例(11.5%)被诊断为基底细胞样癌。所有BSCCE患者的中位生存期为31个月,1年、3年、5年总生存率分别为81.6%、45.9%和29.5%;同期典型食管低分化鳞癌患者的中位生存期为32.5个月,1年、3年、5年总生存率分别为76.1%、47.8%和32.4%(P=0.821)。Cox多因素分析显示,肿瘤发生部位、病理TNM分期均是影响BSCCE手术预后的独立因素。结论 BSCCE恶性程度高,其预后与食管低分化鳞癌相近。Objective Basaloid squamous cell carcinoma of the esophagus （BSCCE） is a rare and distinct patho-logical variant of squamous cell carcinoma, the aim of the study was to investigate the clinical characteristics and treatment modalities of this disease. Method The clinical data of 51 patients with BSCCE that received surgical treatment in the Cancer Hospital and Institute, Chinese Academy of Medical Sciences, from March 1999 to December 2004 were retrospectively analyzed. The long-term survival of BSCCE was compared with that of poorly differentiat-ed squamous cell carcinoma of the esophagus （PSCC） treated in our hospital in the same period. Result For all pa-tients included, there were 5 in stage I, 28 in stage II, 18 in stage III. Among 35 patients received endoscopic biopsy, only 4 cases were diagnosed with BSCCE. The median survival time （MST） of BSCCE was 31 months and the 1-, 3-and 5-year overall survival rates （OS） were 81.6%, 45.9%, and 29.5%, respectively, while the MST of PSCC was 32.5 months, 1-, 3- and 5-year OS were 76.1%, 47.8%, 32.4%, respectively （P=0.821）. In Cox’s multivariate analy-sis, both tumor location and pathological TNM stage were found to be independent prognostic factors. Conclusion Basaloid squamous cell carcinoma is an aggressive disease with poor prognosis close to that of PSCC. Surgical resec-tion, which could help to make a definitive diagnosis and achieve radical resection, should be recommended.

关 键 词：食管癌 基底细胞样鳞癌 手术 预后 

分 类 号：R735.1[医药卫生—肿瘤]