Haruma K, Tokutomi T, Tsuda T, Yoshihara M, Sumii K, Kajiyama G
First Department of Internal Medicine, Hiroshima University School of Medicine, Japan.
Am J Gastroenterol. 1991 Dec;86(12):1723-8.
Twenty-seven patients with superficial esophageal carcinoma were investigated to determine their clinical and pathological features. All 21 male patients were habitual drinkers, and 17 were heavy smokers. Histological examination showed that three tumors were intraepithelial, five were mucosal, and 19 were submucosal. Fifteen of the 27 patients were asymptomatic, including seven of the eight with intraepithelial or mucosal carcinoma. Twelve of the 13 patients with polypoid tumors had submucosal invasion, whereas two patients with flat tumors and four of the seven with erosive tumors had either intraepithelial or mucosal carcinoma. Six of the eight patients with intraepithelial or mucosal carcinoma had normal routine radiological studies. All these eight patients had no lymph node involvement, whereas four of the 19 with submucosal carcinoma had lymph node metastases. An aggressive approach to endoscopy in asymptomatic high-risk individuals (middle-aged male drinkers and smokers) may increase the detection of early esophageal carcinoma, although the cost-effectiveness should be evaluated further. In addition, in the interest of prevention, our results show that encouraging people to stop smoking and limit their alcohol intake to an occasional drink might be an important factor in lessening the risk for esophageal carcinoma.
对27例浅表性食管癌患者进行了研究，以确定其临床和病理特征。21例男性患者均有饮酒习惯，17例为重度吸烟者。组织学检查显示，3例肿瘤为上皮内癌，5例为黏膜癌，19例为黏膜下癌。27例患者中有15例无症状，其中上皮内或黏膜癌的8例中有7例无症状。13例息肉样肿瘤患者中有12例有黏膜下浸润，而2例扁平肿瘤患者和7例糜烂性肿瘤患者中有4例为上皮内或黏膜癌。上皮内或黏膜癌的8例患者中有6例常规影像学检查正常。这8例患者均无淋巴结受累，而19例黏膜下癌患者中有4例有淋巴结转移。对于无症状的高危个体（中年男性饮酒者和吸烟者）采取积极的内镜检查方法可能会增加早期食管癌的检出率，不过其成本效益还需进一步评估。此外，为了预防起见，我们的研究结果表明，鼓励人们戒烟并将饮酒量限制为偶尔饮用，可能是降低食管癌风险的一个重要因素。
