食管恶性肿瘤850例的组织病理学特征分析  

Analysis of histopathological features in 850 cases of esophageal malignant tumor

作　　者：陈慧[1] 詹俊[2] 于钟[2] 钟娃[2] 刘思齐[1] 

机构地区：[1]中山大学孙逸仙纪念医院急诊科,广州510288 [2]中山大学孙逸仙纪念医院消化内科,广州510288

出　　处：《中华消化杂志》2015年第12期816-821,共6页Chinese Journal of Digestion

摘　　要：目的分析10年内850例食管恶性肿瘤患者的组织病理学特征。方法纳入2002年1月至2012年1月被诊断为食管恶性肿瘤的850例患者，回顾性分析其肿瘤部位、大体类型、肿瘤病理类型、TNM分期等。所有数据以例数和百分数表示。结果850例食管恶性肿瘤中，病变位于食管颈段33例（3．9％），食管上段119例（14．0％），食管中上段44例（5．2％），食管中段409例（48．1％），食管中下段123例（14．5％），食管下段122例（14．4％）。大体类型诊断明确的724例食管恶性肿瘤病理类型中，溃疡型最多，为305例（42．I％）；其次是髓质型，为260例（35．9％）；蕈伞型和缩窄型分别为80例（11．0％）和70例（9．7％）；腔内型最少，为9例（1．2％）。850例食管恶性肿瘤中，鳞状细胞癌最多，为794例（93．4％）；其次是小细胞癌，为19例（2．2％）；腺癌较少，仅7例（O．8％）。在确定TNM分期的724例食管肿瘤患者中，Tis、TI、T2、T3、T4期分别为8例（1．1％）、6例（O．8％）、271例（37．4％）、278例（38．4％）、161例（22．2％）。122例下段食管癌中（其中104例具有明确的TNM分期），以鳞状细胞癌为主，为112例（91．8％）；腺癌仅3例（2．5％）；另外可见小细胞癌3例（2．5％），基底细胞样鳞状细胞癌、腺鳞癌、神经内分泌癌、癌肉瘤各1例（各占0．8％）。结论食管恶性肿瘤多位于食管中段，其中鳞状细胞癌占大多数，腺癌较为少见。下段食管癌具有较广的组织病理谱，鳞状细胞癌仍占主导地位，但食管腺癌罕见。Objective To explore the histopathotogical features of 850 patients with esophageal malignant tumor in 10 years. Methods From January 2002 to January 2012, 850 patients diagnosed with esophageal malignant tumor were enrolled. Tumor location, general type, pathological type and TNM stage were retrospectively analyzed. All the data were described as case number and percentage. Results Among the 850 cases of esophageal malignant tumor, 33 lesions （3.9%） located in the neck segment of esophagus, 119 lesions （14.0%） located in the upper segment,44 lesions （5.2%） located in the upper- middle segment, 409 lesions （48.1%） located in the middle segment, 123 lesions （14.5%） located in the middledower segment, 122 lesions （14.40/00） located in the lower segment. Among the 724 cases clearly diagnosed as esophageal malignant tumor by general type, the most cases were ulcer type （305 cases, 42.1%）, followed by medulla type （260 cases, 35.9%）, fungating type （80 cases, 11. 0%） and constrictive type （70 cases, 9. 7%）, and the least cases were intraluminal type （nine cases, 1. 2%）. Among the 850 cases of esophageal malignant tumor, squamous cell carcinoma （794 cases, 93.4 %） was the most common cytological type, followed by small cell carcinoma （19 cases, 2. 2%）, and the least common cytological type was adenocarcinoma （seven cases, 0.8 %）. Among the 724 cases with clear TNM staging, case number of Tis, T1, T2, T3 and T4 stage was eight （1. 1%）, six （0.8%）, 271 （37.4%）, 278 （38.4%） and 161 （22.2%）, respectively. Among the 122 cases of distal esophageal carcinomas （104 cases with clear TNM staging）, most cases were squamous cell carcinoma （112 cases, 91.8%）, the others cases were adenocarcinoma （three cases, 2.5 %）, small cell carcinoma （three cases, 2.5 %）, hasaloid squamous cell, adenosquamous, neuroendocrine carcinomas and careinosarcoma （one case in each type, 0.8~/00）. Conclusions Esophageal carcinoma was mostly located in the midd

关 键 词：食管肿瘤 恶性 食管腺癌 组织病理学特征 

分 类 号：R735.1[医药卫生—肿瘤]