食管癌肉瘤20例病理及其临床表现分析(英文)

Pathologic and Clinical Analysis of Carcinosarcoma of Esophagus (20 Cases)

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资料 ,分析其临床特点 ,以助诊断。方法 :对 2 0例食管癌肉瘤病人的临的床资料进行回顾性研究。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。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”。结论 :食管癌 ,是一种低侵袭性的肿瘤 ,以腔内生长为主。临床表现与食管癌有一定区别 ,“涂抹征”是其典型的X线表现。食管镜活检多显示鳞癌或低分化癌 ,术前较难确诊。

Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide support information for clinical diagnosis. Methods: To review and study the clinical data of 20 patients of esophageal carcinosarcoma. Results: Most of esophageal carcinosarcoma grew like pileus or polypus in esophagus, a few of them were infiltrating. Microscopic examination of the resected specimens indicated that the tumor is composed of sarcomatous element and carcinomatous element (the main element), and the surface of such tumor was covered mostly by carcinoma tissues. The result of biopsy showed that the tumor is squamous cell carcinoma. X-ray examination indicated that there was polypus-like smooth and tidy filling defect in the esophagus of such patient, and its mucous membrane showed “daubing-trace” like characteristics. Conclusion: Carcinosarcoma of esophagus is a tumor of low invasion, which grows mainly in the esophageal lumen. The clinical symptoms of this tumor are different from those of esophagus carcinoma in certain degree. The “daubing-trace” like characteristics is typical of X-ray picture. The results of most endoscopic biopsies demonstrate squamous cell carcinoma or lower differentiation carcinoma, which are difficult for confirmed diagnosis before operation.