原发性食管腺癌外科治疗体会(附105例报告)

Surgical treatment of primary esophageal adenocarcinoma (a report of 105 cases)

目的探讨原发性食管腺癌的临床生物学特征及外科治疗效果。方法回顾性分析105例经手术病理证实的原发性食管腺癌患者的临床资料。结果手术并发症发生率5.7%,手术病死率0.9%;全组共切除淋巴结2140个,平均每例24.3个,其中癌性转移淋巴结462个,转移度21.6%,肿瘤外侵发生率31.2%,淋巴结转移率50.5%。术后5年生存率26.3%,影响预后的主要因素有病变分期、淋巴结转移及淋巴结转移的数量和转移度,肿瘤外侵和手术切除性质。结论本病的生物学特性与肺腺癌基本相似,其发生可能与Barrett食管无明显关系。采用以手术为主的综合治疗可望提高原发性食管腺癌患者的生存率。

Objective To summarize the surgical treatment and clinical biocharacteristics of primary csophageal adenocarcinoma. Methods Clinical data of 105 cases with primary esophageal adenocarcinoma were retrospectively studied. Results The incidence of postoperative complications and operative mortality were 5.7% and 0. 9% ,respectively. 24.3 in each case of the total 2 140 lymph nodes resected （an average of 24.3 per patient） were proved to be positive ,including 462 lymph nodes metastases with the metastases degree of 21.6%, invasion rate of 31.2% and lymph node metastases of 50.5%. The overall 5-year survival rate was 26.3%. The major factors influencing the prognosis were disorder staging, the numbers of lymph node metastases and the metastases degree, tumor invasion as well as surgical resection. Conclusion The biocharacteristics of the primary esophageal adenocarcinoma is basically similar to that of the lung adenocarcinoma,which development is probably not related to the Barrett＇s esophagus. The comprehensive therapy especially surgical resection is hoped to increase the survival rate of primary esophageal adenocarcinoma.