Yamamoto Takahiro, Kuroda Jun-Ichiro, Takezaki Tatsuya, Shinojima Naoki, Hide Takuichiro, Makino Keishi, Nakamura Hideo, Yano Shigetoshi, Nishi Toru, Kuratsu Jun-Ichi
Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860 - 8556, Japan ; Department of Neurosurgery, Saiseikai Kumamoto Hospital, 1-3-5, Chikami, Kumamoto 861- 4193, Japan.
Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860 - 8556, Japan.
Surg Neurol Int. 2014 Sep 22;5:137. doi: 10.4103/2152-7806.141468. eCollection 2014.
Esophageal carcinoma (EC) is a major malignancy with a poor prognosis. Although esophageal cancers rarely metastasize to the brain, the number of patients diagnosed with brain metastases (BM) from EC is steadily increasing. Therefore, the risk factors for BM from EC should be known. Here we reviewed our experiences and the previous literature regarding BM from EC.
Between 2000 and 2013, we retrospectively reviewed the clinical features and neurological findings of 19 patients diagnosed with and treated for BM from EC to determine the clinical risk factors and features.
In all patients, the lesions were partially or completed located in the thoracic esophagus, and the average size of the EC lesion at diagnosis was 5.8 ± 2.9 cm, which was smaller than the previously reported size of EC lesions accompanied by BM. Patients without lung metastases were more common than those with lung metastases. The lesions in the 13 patients included squamous cell carcinoma (SqCC) in 9 (69.2%) and small cell carcinoma (SmCC) in 3 (23.0%). Six patients were not examined. Although there was no trend toward a higher incidence of BM in patients with adenocarcinoma and SqCC, this trend was observed in patients with SmCC. Excluding a single patient with SmCC, all patients had beyond stage III disease at EC diagnosis.
Our study suggests that BM can occur in patients with EC lesions smaller than those previously reported; moreover, SmCC may be a risk factor for BM from EC.
食管癌（EC）是一种预后较差的主要恶性肿瘤。尽管食管癌很少转移至脑，但诊断为食管癌脑转移（BM）的患者数量正在稳步增加。因此，应了解食管癌脑转移的危险因素。在此，我们回顾了我们关于食管癌脑转移的经验及既往文献。
2000年至2013年期间，我们回顾性分析了19例诊断为食管癌脑转移并接受治疗患者的临床特征及神经学表现，以确定临床危险因素及特征。
所有患者病变部分或全部位于胸段食管，诊断时食管癌病变平均大小为5.8±2.9cm，小于既往报道的伴有脑转移的食管癌病变大小。无肺转移的患者比有肺转移的患者更常见。13例患者的病变包括9例（69.2%）鳞状细胞癌（SqCC）和3例（23.0%）小细胞癌（SmCC）。6例患者未进行检查。尽管腺癌和SqCC患者的脑转移发生率没有更高的趋势，但在SmCC患者中观察到了这种趋势。除1例SmCC患者外，所有患者在食管癌诊断时均处于Ⅲ期以上疾病。
我们的研究表明，食管癌脑转移可发生于病变小于既往报道的患者；此外，小细胞癌可能是食管癌脑转移的一个危险因素。
