手术治疗原发性食管腺癌的预后分析及与同期食管鳞癌对比

Analysis of Prognosis for Patients with Primary Esophageal Adenocarcinoma and Distinction from Esophageal Squamous Carcinoma

目的:了解原发性食管腺癌的手术治疗情况及影响患者预后的重要因素,探讨其与同期手术治疗的食管鳞癌的类同和差异。方法:对42例食管腺癌患者的外科治疗结果进行回顾性研究,并与同期1938例外科治疗的食管鳞癌进行对比分析;利用SPSS软件对可能影响原发食管腺癌及鳞癌预后的多个因素进行分析,找出影响预后的因素。结果:食管腺癌患者的男女比为4.3:1,发病中位年龄61岁,平均病程4个月,肿瘤平均长度5cm;手术切除率及手术并发症发生率分别为88.1%和7.1%,术后1、3、5年生存率分别为69.0%、35.7%、16.7%。结论:原发性食管腺癌与食管鳞癌在一般临床特征上相似,腺癌淋巴结转移率高。食管腺癌患者预后取决于肿瘤病理分期、侵犯深度及有无淋巴结转移,早期发现、早期诊断、早期规范根治性手术及综合治疗是改善预后的主要手段。

To determine the factors influencing prognosis of patients with primary esophageal adenocarcinoma and to discuss the difference between esophageal adenocarcinoma and esophageal squamous carcinoma. Methods： The data of 42 cases with esophageal adenocarcinoma treated with surgery were studied retrospectively and were compared with 1938 cases of esophageal squamous carcinoma treated by surgery. SPSS software was used to elucidate the factors influencing the prognosis of patients with these diseases. Results： Of the patients with esophageal adenocarcinoma, the male/female ratio was 4.3：1, the median age was 61, the average course was 4 months and the average length of tumors was 5 cm. The rate of resection and mortality was 88.1% and 7.1%, respectively. The 1-, 3- and 5-year postoperative survival rate of the cases was 69.0%, 35.7% and 16.7%, respectively. Conclusion： The clinical features of primary esophageal adenocarcinoma are similar to those of esophageal squamous carcinoma, and the rate of lymph node metastasis for esophageal adenocarcinoma is high. The prognosis for patients with primary esophageal adenocarcinoma depends on the pathological staging, infiltration and lymph node metastasis. The main means to improve prognosis are early detection, early diagnosis and early standardized radical surgery, as well as combined therapy.