百色地区30例早期食管癌内镜及临床病理特征分析  

The Endoscopic and Clinicopathologic Characteristics of 30 Cases with Early Esophageal Carcinoma in Baise Area

作　　者：蒋旗[1] 胡静[1] 苏建伟[1] JIANG Qi;HU Jing;SU Jian-wei(Department of gastroenterology, Affiliated Hospital of YouJiang Madical University for Nationalities, Baise Guangxi Zhuang Autonomous Region,53300)

机构地区：[1]右江民族医学院附属医院消化内科,广西壮族自治区百色53300

出　　处：《世界最新医学信息文摘》2018年第9期35-36,共2页World Latest Medicine Information Electronic Version

摘　　要：目的通过内镜下早期食管癌表现与临床病理对比,加深对内镜下早期食管癌的认识,提高早期食管癌早期发现率。方法回顾我院内镜下治疗或手术后百色地区30例患者经病理诊断为早期食管癌的临床资料、镜下特点及病理特征。结果男性19例,女性11例,男女比例为1.73:1,发病高峰年龄为50-69岁22例(占73.3%),上段2例(6.7%),中段22例(73.3%),下段6例(20%)。内镜Paris分型:0-Ⅰ型(隆起型)、0-Ⅱa型(浅表隆起型)、0-Ⅱb(浅表平坦型)、0-Ⅱc型(表浅凹陷性)、0-Ⅲ型(凹陷型)分别为:3.3%、13.3%、56.7%、20%、6.7%,日本食道学会将早期食管癌上皮内乳头状毛细血管襻(intrapapillary capillaryloop,IPCL)放大内镜分类分为(A、B分型):其中B1型:17例、B2型11例,B3型:2例。病理分型:鳞癌(15例)、重度不典型增生/原位癌(14例46.7%),腺癌(1例),其中粘膜下层浸润占5例,余均为原位癌或粘膜内癌。结论早期食管癌好发50-69岁男性,食管中段为主,内镜下以浅表型多见、病理鳞癌常见,常规内镜检查联合NBI+放大内镜是发现早期食管癌重要的手段。Objective To explore the endoscopic and clinicopathologic characteristics of early esophageal carcinoma and raise the diagnosis rate of it. Methods A retrospective analysis was made in the 30 cases of the early esophageal carcinoma in baise area proved by endoscopic submucosal dissection（ESD）or operation in our hospital. Results Of the 30 cases（19 men and 11 women）,the ratio of male/female was 1.73：1.the peak incidence of age were from 50 to 69 years.The ratio of the upper esophagus, middle part and lower part was 6.7%,73.3% and 20%, respectively. As for the Paris macrosopic type classification, the percentage of protruding（0-Ⅰ）,slightly elevated（Ⅱ-a）,flat（Ⅱ-b）,depressed（Ⅱ-c）andexcaveted（0-Ⅲ）was 3.3%,13.3%,56.7%,20% and 6.7%, respective. These two exemplary classifications as the Japanese Classification of Magnifying Endoscopy for Early Squamous Cell Carcinoma：A、B. Among them,17 B1 type intrapapillary capillary loop（IPCL） patterns,11 B2 type IPCL patterns,2 B3 type IPCL patterns,The ratio of the hight grade intraepithelial neoplasia/carcinoma in situ,the adenocarcinoma and the squamous carcinoma was 46.7%,50% and 3.3%,respectivel y,14 cases of the hight grade intraepithelial neoplasia/carcinoma,15 cases of intramucosal carcinoma,5 cases of submucosal carcinoma. Conclusion Early esophageal carcinoma often occurs in males of 50 to 69 years old, and median esophagus is the predilection site. The Paris macrosopic type classification：flat（II-b）,depressed（II-c）and squamous carcinoma are its main type.Gastroscopic inspection combined with biopsy is an important method in detecting early esophageal cancer.

关 键 词：早期食管癌 内镜检查 临床病理 巴黎分型 

分 类 号：R735.1[医药卫生—肿瘤]