240例无症状中晚期食管癌患者临床病理特征分析  

Clinicopathological Characteristics of 240 Asymptomatic Patients with Advanced Esophageal Cancer

作　　者：李欣然 赵学科[1] 宋昕[1] 杨苗苗[1] 徐瑞华 魏梦霞 韩文莉 雷玲玲 孟超龙 胡守佳[1] 程锟 王盼盼[1] 钟侃 胡景峰 王伟[1,2] 杨媛啧[1] 陈瑶 李留玉 吉佳佳 王立东 LI Xin-ran;ZHAO Xue-ke;SONG Xin;YANG Miao-miao;XU Rui-hua;WEI Meng-xia;HAN Wen-li;LEI Ling-ling;MENG Chao-long;HU Shou-jia;CHENG Kun;WANG Pan-pan;ZHONG Kan;HU Jing-feng;WANG Wei;Yang Yuan-ze;CHEN Yao;LI Liu-yu;JI Jia-jia;WANG Li-dong(State Key Laboratory of Esophageal Cancer Prevention&Treatment and Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital,Zhengzhou University,Zhengzhou450052,China;Department of Pathology and Pathophysiology,School of Basic Medicine Science,Zhengzhou University,Zhengzhou 450051,China)

机构地区：[1]郑州大学第一附属医院省部共建食管癌防治国家重点实验室,河南郑州450052 [2]郑州大学基础医学院病理学与病理生理学教研室,河南郑州450001

出　　处：《食管疾病》2020年第4期288-293,共6页Journal of Esophageal Diseases

基　　金：国家自然科学基金(U1301227)。

摘　　要：目的分析食管癌高发区无症状人群早期癌筛查中发现的无症状中晚期食管癌患者临床病理特征及其可能的原因。方法在食管癌高发区进行无症状高危人群胃镜筛查,并对筛查发现食管癌且最终在医院确诊并治疗的患者进行持续跟踪。最终纳入了240例无症状并且进行了术后病理诊断,且按照临床分期标准符合中晚期的患者。结果240例无症状中晚期患者中60~70岁女性、职业为农民的62例(25.83%),60~70岁男性、职业为农民的39例(16.25%);男性最常见的大体类型为侵蚀型(20.24%),女性为溃疡型(24.36%)。无论男性还是女性患者,淋巴结转移阴性的概率均高于淋巴结转移阳性(55.77%VS 44.23%,63.10%VS 36.90%)。肿瘤长径≥4 cm且年龄在60~70岁之间的髓质型18例(7.50%),溃疡型12例(5.00%)。结论即使食管癌已经进展至中晚期,患者仍然有可能未出现各类症状,故需要寻找潜在的分子生物学标记物作为早期筛查手段。Objective To analyze the clinicopathological characteristics and possible causes of asymptomatic middle-advanced esophageal cancer patients found in the early cancer screening of asymptomatic people in the high-incidence area of esophageal cancer.Methods Gastroscopy screening was used for asymptomatic and high-risk populations in the high-incidence area of esophageal cancer,and patients whose esophageal cancer is found on the screening and finally diagnosed and treated in the hospital were followed up continuously.240 cases of asymptomatic patients who underwent postoperative pathological diagnosis and met the middle-advanced stage of clinical staging standard were included.Results Among 240 asymptomatic patients in the middle and late stages,62 cases(25.83%)of women aged 60~70 are farmers,and 39 cases(16.25%)of men aged 60~70 are farmers;the most common type in the male is erosion type(20.24%),while the type in the women are ulcerated(24.36%).Regardless of male or female patients,the probability of negative lymph node metastasis is higher than that of positive lymph node metastasis(55.77%VS 44.23%,63.10%VS 36.90%).There were 18 cases(7.50%)of medullary type with tumors long diameter≥4 cm and age between 60~70 years old,and 12 cases(5.00%)of ulcer type.Conclusion Even if esophageal cancer has progressed to the middle and advanced stages,the patient may still not have symptoms.Therefore,it is necessary to find potential molecular biomarkers as an early screening method.

关 键 词：食管癌 中晚期 无症状患者 

分 类 号：R735.1[医药卫生—肿瘤]