原发性食管小细胞癌临床特点与综合治疗

Clinicopathologic Character and Multi-modality Treatments of Primary Small Cell Carcinoma of Esophagus

目的探讨原发性食管小细胞癌的临床病理特征及治疗方法的选择。方法回顾性分析9例原发性食管小细胞癌的临床表现、病理特征、治疗方法及结果。结果TNM分期Ⅱ期3例,Ⅲ期4例,Ⅳ期2例;单纯手术1例,手术+化疗6例,放疗+化疗2例。免疫组化染色NSE阳性9例,Syn、CgA阳性7例,合并糖尿病5例,GLU均阳性。1,2,3年生存率分别为55.6%(5/9),33.3%(3/9)和12.5%(1/8),平均生存期18.1个月。结论原发性食管小细胞癌恶性程度高,TNM分期和治疗方法是影响预后的重要因素,早期发现、综合治疗是延长生存期的关键。

Objective To investigate the clinicopathologic character and effective therapy in primary small cell carcinoma of esophagus. Methods Nine patients with primary esophageal small cell carcinoma were retrospectively analyze on clinical symptoms, pathologic character, type of treatment and outcome. Results According to the TNM classification in esophageal carcinoma, three patients had a stage Ⅱ disease, four had a stage Ⅲ disease, and the other two had a stage Ⅳ disease. One patient received surgery alone. Six patients underwent surgery and combination chemotherapy. Two patients underwent radiotherapy and combination chemotherapy. Immunohistochemical staining positive for NSE is 9 cases, Syn and CgA is 7 cases. GLU exhibited strong immunoreactivity in all specimens with diabetes. The 1, 2, and 3-year survival rate of them were 55.6%（5/9）, 33.3%（3/9） and 12.5% （1/ 8） respectively, average 18.1 months. Conclusion Primary small cell carcinoma of esophagus is a kind of highly malignant tumor. The TNM staging and type of treatment are the important influencing factors in prognosis. The key point is early diagnosis and multi-modality treatments to prolong survival term.