Kuwano H, Ikebe M, Baba K, Kitamura K, To Y, Adachi Y, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University.
Nihon Geka Gakkai Zasshi. 1992 Sep;93(9):937-9.
I. Serial histopathologic study of esophageal squamous cell carcinoma. A review of 335 cases of squamous cell carcinoma disclosed 55 cases (16.4%) with glandular components in addition to the ordinary component of squamous cell carcinoma, suggesting that this type of esophageal tumor had originated not only from the covering squamous epithelium but from esophageal gland or ductal epithelium. Intra-epithelial carcinoma concomitant with squamous cell carcinoma was seen in 95 cases (28.4%). The incidences of coexistence in such lesion were higher in the groups of early stage esophageal cancer. These observations support the concept of field carcinogenesis of esophageal cancer. II. Histopathologic study of squamous epithelial dysplasia. Among 91 cases without preoperative treatment, there were 40 dysplastic lesions in 23 cases (25.3%). The continuity of dysplasia to the carcinoma was 48.3% and it was often encountered in severe dysplasia rather than in moderate or mild dysplasia, suggesting some relationship between the severity of dysplasia and carcinoma. III. Immunohistochemical study of EGF and c-myc. Among 27 cases, EGF was positive in 10 (37.0%). c-myc was positive in 18 (66.7%) not only cancer but normal epithelium suggesting that some change of products of oncogene occurred also in the normal epithelium of the patients of esophageal cancer.
一、食管鳞状细胞癌的系列组织病理学研究。对335例鳞状细胞癌的回顾显示,除了普通的鳞状细胞癌成分外,55例(16.4%)还伴有腺性成分,这表明这种类型的食管肿瘤不仅起源于覆盖的鳞状上皮,还起源于食管腺或导管上皮。95例(28.4%)伴有鳞状细胞癌的上皮内癌。在早期食管癌组中,此类病变共存的发生率更高。这些观察结果支持了食管癌的场癌化概念。二、鳞状上皮发育异常的组织病理学研究。在91例未经术前治疗的病例中,23例(25.3%)有40个发育异常病变。发育异常与癌的连续性为48.3%,且在重度发育异常中比在中度或轻度发育异常中更常出现,提示发育异常的严重程度与癌之间存在某种关系。三、表皮生长因子(EGF)和c-myc的免疫组织化学研究。在27例病例中,10例(37.0%)EGF呈阳性。18例(66.7%)c-myc呈阳性,不仅癌组织阳性,正常上皮也阳性,这表明在食管癌患者的正常上皮中也发生了癌基因产物的某些变化。