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[早期食管癌的预后因素]

[Prognostic factors in early esophageal cancer].

作者信息

Hirayama K, Mori S

机构信息

Second Dept. of Surgery, Tohoku University School of Medicine.

出版信息

Gan To Kagaku Ryoho. 1990 Jan;17(1):37-45.

PMID:2297237
Abstract

During the period from 1975 through 1988, 405 thoracic esophageal carcinoma were resected in our department. Among them, superficial carcinoma was proved in 50 cases. The prognosis of these 50 patients with superficial carcinoma has been analyzed in regard to the prognostic factors. As for the clinico-pathological findings, there were no evident differences in mean age, sex distribution and main location of the lesions between superficial cases and overall resected cases. The distribution of depth of invasion was as follows; ep 4 cases, mm 7 cases and sm 39 cases. The number of patients with invasion to submucosal layer had included the majority of the superficial cases. Lymph node metastasis was proved in 17 cases, and 16 of them had the invasion to the submucosal layer. On the other hand, neither patient with invasion to ep layer had lymph node metastasis, however, in one of seven cases with invasion to mm layer, lymph node metastasis to second group node was proved. The lesions have been resected through thoracotomy in 48 patients out of 50 cases. Blunt dissection has been carried out upon only two cases. The 5-year survival rate of superficial carcinoma was 61.7%, which was clearly better than that of all patients resected in the same period (31.6%). The prognosis distinctly correlated with the depth of invasion; 5-year survival rate of ep, mm and sm cases were 100%, 83.7% and 54.3%, respectively. We experienced no recurrence in case of ep or mm. As for sm cases, lymph node metastasis and/or vessel invasion were most dominant prognostic factors.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1975年至1988年期间,我科共切除405例胸段食管癌。其中,经病理证实为浅表癌的有50例。对这50例浅表癌患者的预后因素进行了分析。就临床病理表现而言,浅表癌病例与整体切除病例在平均年龄、性别分布及病变主要部位方面无明显差异。浸润深度分布如下:上皮内癌(ep)4例,黏膜内癌(mm)7例,黏膜下层癌(sm)39例。浸润至黏膜下层的患者占浅表癌病例的大多数。17例证实有淋巴结转移,其中16例浸润至黏膜下层。另一方面,浸润至上皮内癌层的患者均无淋巴结转移,然而,7例浸润至黏膜内癌层的患者中有1例证实有第二组淋巴结转移。50例中有48例经开胸手术切除病变,仅2例行钝性分离。浅表癌的5年生存率为61.7%,明显高于同期所有切除患者的生存率(31.6%)。预后与浸润深度明显相关;上皮内癌、黏膜内癌和黏膜下层癌的5年生存率分别为100%、83.7%和54.3%。上皮内癌或黏膜内癌病例无复发。对于黏膜下层癌病例,淋巴结转移和/或血管侵犯是最主要的预后因素。(摘要截选至250词)

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