Kuwano Hiroyuki, Egashira Akinori, Araki Kohshi, Saeki Hiroshi, Kawaguchi Hidetoshi, Morita Masaru, Kitamura Kaoru, Sugimachi Keizo
Department of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, Gunma, Japan.
Hepatogastroenterology. 2004 Nov-Dec;51(60):1713-6.
BACKGROUND/AIMS: The multiple occurrence of primary squamous cell carcinoma of the esophagus is often observed, and most such occurrences are double cancers. There have also been some cases with three or more intra-esophageal cancers, however, no detailed clinicopathologic study has yet been performed in the literature.
Two hundred and fifty patients of primary esophageal squamous cell carcinoma without preoperative treatment that underwent esophageal resection were re-evaluated by serial histopathologic investigations and we analyzed the data of ten patients with three or more intraesophageal cancers.
The clinical and histopathologic characteristics were as follows; 1) all but one of the cases were male, 2) all patients had a history of both heavy smoking and drinking but only one case had a family history of esophageal cancers among their siblings, 3) the depth of invasion in the carcinomas was restricted to within the submucosal layer of the esophageal wall, which was defined as superficial esophageal carcinoma, almost all (90%) of the cases accompanied esophageal squamous epithelial dysplasia.
Based on these prominent characteristics of considerable multiple intra-esophageal cancers, a new clinical entity of "esophageal field cancers" could thus be suggested.
背景/目的：食管原发性鳞状细胞癌的多发现象较为常见，且多数为双癌。也有一些病例存在三个或更多的食管内癌，但文献中尚未进行详细的临床病理研究。
对250例未经术前治疗而行食管切除术的原发性食管鳞状细胞癌患者进行了系列组织病理学复查，并分析了10例有三个或更多食管内癌患者的数据。
临床和组织病理学特征如下：1）除1例为女性外，其余均为男性；2）所有患者均有大量吸烟和饮酒史，但只有1例患者的兄弟姐妹中有食管癌家族史；3）癌的浸润深度局限于食管壁黏膜下层以内，即定义为浅表食管癌，几乎所有病例（90%）伴有食管鳞状上皮发育异常。
基于食管内多个癌灶的这些显著特征，可提出“食管区域癌”这一新的临床实体。
