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目的 食管癌肉瘤是一种罕见病 ,通过回顾分析本组较大样本食管癌肉瘤的病理及临床特点 ,探讨其诊断治疗。方法 对 2 0例食管癌肉瘤病人的临床资料进行回顾性分析。结果 食管癌肉瘤多为覃伞样、息肉样腔内生长 ,个别呈浸润生长。光镜下肉瘤与癌两种成份共存 ,瘤体以肉瘤成分为主 ,表面及蒂多分布癌组织 ,活检常显示为鳞癌 ,故术前多不能明确诊断。2 0例患者中 9例侵犯粘膜层 ,1例浅肌层 ,4例深肌层 ,6例侵犯外膜。 4例出现淋巴结转移 ,淋巴转移率 2 0 % ,转移成分 3例鳞癌 ,1例肉瘤。手术切除率 10 0 %。 1、3、5年生存期分别为 85 %、6 8%、6 8%。结论 食管癌肉瘤是一种低侵袭性 ,低淋巴转移率 ,预后尚佳的肿瘤。X线表现为食管腔内息肉样的充盈缺损 ,轮廓较为光滑整齐 ,粘膜显示“涂抹征”。食管镜活检多显示鳞癌或低分化癌 ,术前难以确诊。治疗以手术切除为主 ,必要时辅以放化疗
Objective Esophageal sarcoma is a rare disease, by reviewing the larger sample of esophageal sarcoma in this group of pathological and clinical features, to explore the diagnosis and treatment. Methods The clinical data of 20 esophageal sarcoma patients were retrospectively analyzed. The results of esophageal sarcoma mostly Tan umbrella like, polyp-like cavity growth, were infiltration of individual growth. Light microscopic sarcoma and cancer coexist in two components, the main sarcoma tumor components, surface and Tissue distribution of cancer, biopsy often showed squamous cell carcinoma, it can not be more clear diagnosis before surgery. In 20 patients, 9 cases invaded the mucosa, 1 case of superficial myometrial muscle, 4 cases of deep myometrium and 6 cases of invasion of the adventitia. 4 cases of lymph node metastasis, lymph node metastasis rate of 20%, transfer of 3 cases of squamous cell carcinoma, 1 case of sarcoma. Surgical resection rate 10 0%. The 1-, 3- and 5-year survival rates were 85%, 68% and 68% respectively. Conclusion Esophageal sarcoma is a kind of tumor with low invasiveness, low lymphatic metastasis and good prognosis. X-ray showed polypoid filling of the esophageal cavity defect, the outline is more smooth and tidy, the mucous membrane shows “smear sign.” Esophageal biopsy showed more squamous cell carcinoma or poorly differentiated carcinoma, difficult to diagnose before surgery. Surgical treatment of the main treatment, if necessary, accompanied by radiotherapy and chemotherapy