原发性食管腺癌(附47例报告)

Primary Adenocarcinoma of the Esophagus. A Report of 47 Cases

我院于1979年4月至1989年10月间,经手术切除和病理证实的1776例食管癌中,原发性食管腺癌47例(2.65％)。男32例,女15例。年龄为39～68岁(中位55.7岁)。前24例细胞学检查,21例诊断为食管鳞癌,误诊率87:75％。47例均行食管癌切除。其中34例行食管胃弓上吻合术,13例行颈部吻合术。术后病理检查区域淋巴结有转移者24例,切端残存癌3例。切除后5年生存率28.6％。作者认为食管腺癌的确诊必须根据手术标本作组织学分析。

Between April 1979 and October 1989, 1 , 776 patients with esophageal carcinoma were operated upon and verified pathologically. Among them, 17 were primary adenocarcinoma. accounting for 2. 65%.There were 32 males and 15 females. Age ranged from 39 to 68 yrs,with a mean of 55. 7 yrs. Of the 24 cases who had prcoperative cytologic examination 21 (87. 5%)misdiagnosed as squamous cell carcinoma. All these patients were operated upon with esophagee-tomy (gastro-esophageal anastomosis above the aortic arch in 34 ,in the neck in 13). Postoperative pathologic examination showed that 24 had regional metastatic lymphadenopathy, 3 had residual tumor at the section edge. The overall 5-year survival rate in this group was 28. 6%. It is concluded that the definitive diagnosis of adenocarcinoma of esophagus must be based on thorough pathological examination of the resected specimen.