Morita M, Kuwano H, Yasuda M, Watanabe M, Ohno S, Saito T, Furusawa M, Sugimachi K
Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
Cancer. 1994 Dec 1;74(11):2889-95. doi: 10.1002/1097-0142(19941201)74:11<2889::aid-cncr2820741102>3.0.co;2-k.
The biologic significance of esophageal dysplasia has not yet been completely elucidated, especially regarding the process of multiple occurrences of squamous cell carcinoma.
The multiplicity of dysplasia in 73 patients with solitary carcinoma of the esophagus (Group I) and 21 with multiple carcinomas (Group II) was compared in surgically resected specimens.
Thirty-nine second carcinomas were identified in 13 patients of Group II, and all were superficial. The incidences of five or more isolated dysplasias in cases without continuity to a carcinomatous lesion, was 6.8% and 66.7% in Groups I and II, respectively (P < 0.01). In a case with three or more carcinomas, the incidence increased to 84.6%. The coexistence of all grades of isolated dysplasias was observed in 10 patients (47.6%) in Group II but in only 6 patients (8.2%) in Group I (P < 0.01).
These findings suggest that various degrees of evolving biologically related lesions, such as dysplasia and carcinoma, can occur multicentrically in the same esophagus.
食管发育异常的生物学意义尚未完全阐明，尤其是关于鳞状细胞癌多次发生的过程。
在手术切除的标本中，比较了73例食管单发癌患者（第一组）和21例多发癌患者（第二组）发育异常的多样性。
在第二组的13例患者中发现了39处第二原发癌，均为浅表性。在与癌灶无连续性的病例中，5处或更多处孤立发育异常的发生率在第一组和第二组中分别为6.8%和66.7%（P<0.01）。在有3处或更多处癌的病例中，该发生率增至84.6%。在第二组中，10例患者（47.6%）观察到各级孤立发育异常并存，但在第一组中仅6例患者（8.2%）出现这种情况（P<0.01）。
这些发现表明，不同程度的生物学相关病变，如发育异常和癌，可在同一食管内多中心发生。
