Natsugoe S, Baba M, Shimada M, Kijima F, Kusano C, Yoshinaka H, Mueller J, Aikou T
First Department of Surgery, Kagoshima University School of Medicine, Japan.
Hepatogastroenterology. 1999 Sep-Oct;46(29):2854-8.
BACKGROUND/AIMS: The prognosis of patients with esophageal carcinoma remains unsatisfactory. The purpose of this study was to clarify the clinicopathologic characteristics of asymptomatic patients.
We retrospectively compared 78 cases of asymptomatic esophageal carcinoma (AEC) with 341 cases of symptomatic esophageal carcinoma (SEC).
In 47 of 78 patients with AEC, the tumors were discovered by mass screening and in 31 patents by follow-up examination for other disease. Nearly 70% of the patients with AEC had a carcinoma in situ (Tis) or T1 tumor, whereas nearly 70% of the patients with SEC had T3 or T4 tumors. The incidences of lymph node metastasis, lymphatic invasion and vascular invasion were significantly lower in patients with AEC than in those with SEC. The 5-year survival rate in AEC and SEC were 59.3% and 22.9%, respectively. With regard to the cause of death, 26.8% (11/41) of patients with AEC and 59.9% (166/277) of patients with SEC died of esophageal carcinoma.
In order to improve the prognosis of esophageal carcinoma, an effort should be made to detect early esophageal carcinoma among patients at risk for tumors when they are still asymptomatic.
背景/目的：食管癌患者的预后仍不尽人意。本研究旨在阐明无症状患者的临床病理特征。
我们回顾性比较了78例无症状食管癌（AEC）患者和341例有症状食管癌（SEC）患者。
在78例AEC患者中，47例通过大规模筛查发现肿瘤，31例通过其他疾病的随访检查发现。近70%的AEC患者患有原位癌（Tis）或T1期肿瘤，而近70%的SEC患者患有T3或T4期肿瘤。AEC患者的淋巴结转移、淋巴浸润和血管浸润发生率显著低于SEC患者。AEC和SEC的5年生存率分别为59.3%和22.9%。关于死亡原因，26.8%（11/41）的AEC患者和59.9%（166/277）的SEC患者死于食管癌。
为了改善食管癌的预后，应努力在有肿瘤风险的患者仍无症状时检测早期食管癌。
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