7例食管癌肉瘤的诊治分析

Cinical Experience in Diagnosis and Treatment of Esophagus Carcinosarcoma

目的:探讨食管癌肉瘤的病理特征、临床特点和治疗方法。方法:对7例食管癌肉瘤患者的临床表现、术前影像学、内窥镜资料、外科治疗结果进行回顾性分析。结果:食管癌肉瘤患者的主要临床症状为逐渐加重的下咽不顺,平均病程4.1个月。好发于食管中段。多为息肉样腔内生长,有短蒂和食管壁相连,个别呈浸润生长。全组7例均行食管部分切除,无手术死亡及并发症。光镜下癌和肉瘤两种成分共存,腔内型者瘤体多以肉瘤成分为主,癌多局限于蒂的基底部粘膜。全组术后随访6例,均健在。结论:食管癌肉瘤是一种侵袭性差,淋巴结转移率低,预后较好的肿瘤。手术切除是其主要的治疗方法。

Objective：To evaluate the pathological and clinical characteristics, treatment methods of esophageal carcinosarcoma. Methods Clinical feature, preoperative radiology, esophagoscopy and prognosis of surgical treatment were retrospectively analyzed in 7 patients with esophageal carcinosareoma. Results： Progressive dysphagia was the most common presenting symptom, the mean duration was 4. 1 months. Usually the lesions were found in the mid portion of esophagus. Most of the tumors were ploypoid in shape and protruded into the lumen of the esophagus with a short pedicle. All 7 patients received partial e sophageal resection without morbidity and 30-day mortality. Microscopically the tumors were composed of both carcinomatous and sarcomatous elements. Usually the sarcomatous element formed the bulk of the lesion and the carcinomatous element loca ted at the base of the pedicle. 6 cases of this group were followed up, in which all of them were still alive. Conclusion：Ksophais an independent entity with little invasiveness, low lymph node metastasis and good prognosis. Surgica resection is the main treatment.