应用病理大切片确定食管癌主瘤周围原位癌分布情况的研究

A study on distribution of cancer in situ around the primary tumor of esophageal carcinoma in pathological large

目的利用病理大切片对食管癌主瘤周围原位癌分布情况进行深入探讨,可为确定手术的适宜切除长度提供依据。方法收集食管鳞癌手术标本70例,制成病理大切片,在显微镜下观察食管癌主瘤周围原位癌的分布情况,根据等比回缩法将镜下长度推算为术中实际长度。结果(1)70例中有22例(31．4％)患者有主瘤周围原位癌,其中近端4例,远端10例,两侧均有8例。近端有7例主瘤相连,远端有8例与原发肿瘤相连。(2)近端原位癌长径最长者为4．00 cm,近端原位癌灶内缘距主瘤最远者为4．43 cm,近端原位癌灶外缘距主瘤最远者为4．83 cm。远端食管癌周围原位癌长径最长者为12．00 cm,远端原位癌灶内缘距主瘤最远者为7．73 cm,远端原位癌灶外缘距主瘤最远者为12．00 cm。结论食管癌主瘤周围原位癌的发生率高,分布范围广,确定食管癌手术的适宜切除长度必须考虑到这个因素。

Objective To study distribution of cancer in situ around primary tumor of esophageal carcinoma. Methods Resected specimens from seventy patients with esophageal squamous cell carcinomas were collected for study. Specimens were made into the large pathological slices. The lengths of cancer in situ around the primary tumor were measured. The actual lengths during the operation were calculated by the principle of relative shrinkage. Results 22 of the 70 patients（ 31.4% ） had cancer in situ around the primary tumor. 4 were in proximal side, 10 were in distal side, 8 were in both side. In the proximal side, the longest cancer in situ was 4. 00 cm, the longest distance between the inner edge of the cancer in situ and the main lesion was 4.43 cm, the longest distance between the outer edge of the cancer in situ and the main lesion was 4. 83 cm. In distal side, the longest cancer in situ was 12. 00 cm, the longest distance between the inner edge of the cancer in situ and the main lesion was 7.73 cm, the longest distance between the outer edge of the cancer in situ and the main lession was 12. 00 cm. Conclusion Cancer in situ around primary tumor of esophageal carcinoma occur frequently and its expansion is wide. To assess the optimal surgical resection length for esophageal carcinoma, we need to pay attention to cancer in situ around the primary tumor.