食管癌放射治疗后肺组织病理学变化

Pathologic changes in the lung following radiotherapy for esophageal carcinoma

背景与目的:食管癌放疗后并发症特别是肺部并发症是是胸外科治疗领域中的难点之一。我们通过研究食管癌放射治疗后肺组织的损伤程度及临床病理特征,以期为临床更好的治疗提供理论基础。方法:对我院食管癌放射治疗后再手术的部分病例,手术中于放射野和非放射野分别取肺组织标本,术后进行光镜及电镜检查观察组织结构变化。结果:同期放射野和非放射野肺组织变化基本一致,主要呈急性及亚急性反应和慢性纤维化反应。结论:食管癌放疗时两肺虽有屏蔽,但从观察结果来看,放射野与非放射野同期病理变化大致相同,随放射治疗的剂量和病程的不同呈现急性、亚急性和慢性炎症反应过程。

Background and purpose： One of the difficulties encounted is to treat post-operative complications especially pulmonary complications for patients with esophageal carcinoma who had received radiotherapy. We studied the severity as well as clinical and pathological features of lung injury following radiotherapy for esophageal carcinoma to set up a theoretical foundation for future clinical treatments. Methods： Patients with esophageal carcinoma who had received radiotherapy were treated with surgery; specimens of lung tissue were procured from radiation and non-radiation fields and observed by light and electron microscopy. Results： The pathological changes in the lung were similar for radiation and non-radiation fields, mainly acute, sub-acute, or chronic inflammations. Conclusions： Efforts were made to shield the lungs during radiotherapy for esophageal carcinoma, but the pathological changes in the lung were similar for radiation and non-radiation fields; acute, sub-acute, and chronic inflammations were more due to different doses and disease stages.