同时性多发早期食管癌和上皮内瘤变主病灶与副病灶临床病理特征的比较  

Comparison of clinicopathological characteristics of main and accessory lesions in patients with synchronous multiple early esophageal cancer and intraepithelial neoplasia

作　　者：徐闪闪 柴宁莉[2] 令狐恩强 王沙沙[2] 冯秀雪[2] 李宝[2] Xu Shanshan;Chai Ningli;Linghu Enqiang;Wang Shasha;Feng Xiuxue;Li Bao(Nankai University School of Medicine,Tianjin 300071,China;Department of Gastroenterology and Hepatology,The First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]南开大学医学院,天津300071 [2]解放军总医院第一医学中心消化内科,北京100853

出　　处：《中华消化内镜杂志》2021年第12期1008-1012,共5页Chinese Journal of Digestive Endoscopy

基　　金：国家重点研发计划(2016YFC1303601)。

摘　　要：目的比较同时性多发食管病变(synchronous multiple esophageal lesions,SMEL,包括早期食管癌和上皮内瘤变)主副病灶的临床病理特点,并探讨其关联性。方法回顾性分析2006年11月—2019年9月于解放军总医院第一医学中心接受内镜治疗的80例SMEL患者的资料,将病灶分为主病灶和副病灶,总结临床病理特点,并探讨70例双发SMEL患者主副病灶在内镜分型、病变位置、病理类型和浸润深度等方面的关联程度。结果研究纳入的80例SMEL患者年龄为(61.3±8.32)岁,男性多见(83.8%,67/80)。有吸烟和饮酒史的均为57例(71.2%)。70例双发SMEL主病灶和副病灶长径存在正相关(r=0.464,P<0.001);主副病灶的内镜分型(P=0.115)、病变位置(P=0.340)及浸润深度(P=0.555)不具有一致性,但病理类型具有一致性(P<0.001),一致率为50.0%(35/70)。结论多数SMEL患者为有吸烟史和饮酒史的老年男性,在发现一个病灶时,应警惕多发病灶存在可能,并注意主副病灶之间的关联性,避免漏诊。Objective To compare the clinicopathological characteristics of main and accessory lesions in patients with synchronous multiple esophageal lesions(SMEL,i.e.early esophageal cancer and intraepithelial neoplasia)and to explore their correlation.Methods Data of 80 patients with SMEL treated by endoscopic resection in The First Medical Center of Chinese PLA General Hospital from November 2006 to September 2019 were retrospectively analyzed,and the clinicopathological characteristics as well.The lesions were divided into main and accessory lesions,and their correlation in macroscopic type,lesion location,pathological type and invasion depth in 70 patients with double SMEL were investigated.Results The age of 80 patients with SMEL was 61.3±8.32 years,more common in males(83.8%,67/80).Fifty-seven patients(71.2%)had a history of smoking and drinking,respectively.There was a positive correlation between the size of main and accessory lesions in the 70 patients with double SMEL(r=0.464,P<0.001).The macroscopic type(P=0.115),location(P=0.340)and depth of invasion(P=0.555)of the main and accessory lesions were not correlated,but the pathological type had high correlation(P<0.001).The consistency rate was 50.0%(35/70).Conclusion Most SMEL patients are elderly males with a history of smoking and drinking.When one lesion is found,there is high possibility of multiple lesions.Physicians should be aware of the correlation between main and accessory lesions to avoid missed diagnosis.

关 键 词：肿瘤 多原发性 早期食管癌 上皮内瘤变 同时性 临床病理特征 

分 类 号：R735.1[医药卫生—肿瘤]