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[食管癌手术切除最佳长度研究中的大体病理切片]

[Giant pathologic section in the study of optimal length of surgical resection for esophageal carcinoma].

作者信息

Ma Guo-wei, Rong Tie-hua, Wu Qiu-liang, Long Hao, Fu Jian-hua, Lin Peng, Huang Zhi-fan, Zeng Can-guang, Li Xiao-dong, Zhang Xu, Zhang Lan-jun, Wang Jun-ye, Hu Yi, Deng Bang-fa

机构信息

Cancer Center, Sun Yat-Sen University, Guangzhou 510060, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2003 Sep;25(5):472-4.

Abstract

OBJECTIVE

To study the optimal surgical resection length for esophageal carcinoma.

METHODS

Specimens of seventy patients with esophageal squamous cell carcinoma resected and collected in our hospital were made into pathologic giant sections. Direct intramural infiltration, multicentric carcinogenic lesion and leaping metastasis were observed in the large slice by microscope. The actual length during the operation was calculated by the ratio of shrinkage.

RESULTS

Direct intramural infiltration was found in 51 (72.9%) patients, 39 proximal and 36 distal to the tumor. The mean length of direct intramural infiltration was 0.9 +/- 0.8 cm (4.0 cm maximum) proximally and 0.5 +/- 0.3 cm (2.0 cm maximum) distally. Multicentric carcinogenic lesion was found in 11 (15.7%) patients, 5 proximally, 8 distally and 2 on both sides. Proximal to the tumor, the mean distance between the multicentric carcinogenic lesion and the main lesion plus the length of the multiple carcinogenic lesion was 3.2 +/- 1.5 cm (4.7 cm maximum). Distal to the tumor, it was 3.6 +/- 2.4 cm (9.1 cm maximum). Leaping metastasis was found in 9 (12.9%) patients, 7 proximally and 4 distally. The mean distance between the leaping metastasis and the main lesion plus the length of the leaping metastatic lesion was 1.9 +/- 0.6 cm (2.9 cm maximum) proximally and 1.4 +/- 1.0 cm (2.7 cm in maximum) distally.

CONCLUSION

The optimal surgical resection length for esophageal carcinoma should be at least 5 cm proximal to the tumor and total length on the distal side.

摘要

目的

研究食管癌的最佳手术切除长度。

方法

将我院收治的70例食管鳞状细胞癌切除标本制成病理巨片。通过显微镜观察大片标本中的壁内直接浸润、多中心癌灶及跳跃转移情况。根据收缩率计算手术中的实际长度。

结果

51例(72.9%)患者存在壁内直接浸润,肿瘤近端39例,远端36例。壁内直接浸润的平均长度近端为0.9±0.8cm(最大4.0cm),远端为0.5±0.3cm(最大2.0cm)。11例(15.7%)患者存在多中心癌灶,近端5例,远端8例及双侧2例。肿瘤近端,多中心癌灶与主病灶的平均距离加上多中心癌灶的长度为3.2±1.5cm(最大4.7cm)。肿瘤远端为3.6±2.4cm(最大9.1cm)。9例(12.9%)患者存在跳跃转移,近端7例,远端4例。跳跃转移与主病灶的平均距离加上跳跃转移灶的长度近端为1.9±0.6cm(最大2.9cm),远端为1.4±1.0cm(最大2.7cm)。

结论

食管癌的最佳手术切除长度应为肿瘤近端至少5cm及远端全长。

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