Seki M
Department of Surgery, Cancer Institute Hospital, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1991 Oct;92(10):1426-35.
Intramural metastasis and microscopical lymphatic permeation (distant-ly) distant more than 5mm from primary lesion were evaluated clinicopathologically in 207 patients with esophageal cancer, to reveal intramural lymphatic metastasis in esophageal cancer. Thirty-one lesions of intramural metastasis in 21 patients (10%) and 85 distant-ly lesions in 19 patients (9%) were observed. Both lesions existed mainly in lpm or sm layer and located within 5cm from primary lesion. As a direction of metastasis, intramural metastasis existed almost equivalently oral and anal from primary lesion, but distant-ly existed slightly more frequently in anal direction. When intramural metastatic lesion was recognized oral from primary lesion, lymph node involvement of the upper mediastinum was present in 67% of cases. On the other hand, intramural metastasis was seen anal from primary lesion and lymph node involvement of upper paragastric region was present in 100% of cases. Patients with intramural metastasis showed poor prognosis of one year of 50% survival period.
对207例食管癌患者的壁内转移和显微镜下淋巴渗透（远处）（距原发灶超过5mm）进行临床病理评估，以揭示食管癌的壁内淋巴转移情况。观察到21例患者（10%）出现31处壁内转移灶，19例患者（9%）出现85处远处转移灶。两种转移灶主要存在于黏膜下层或黏膜肌层，且位于距原发灶5cm范围内。作为转移方向，壁内转移在原发灶的口侧和肛侧出现的概率几乎相同，但远处转移在肛侧出现的频率略高。当壁内转移灶出现在原发灶的口侧时，67%的病例出现上纵隔淋巴结受累。另一方面，当壁内转移出现在原发灶的肛侧时，100%的病例出现胃上段区域淋巴结受累。出现壁内转移的患者预后较差，一年生存期的生存率为50%。
