碰撞癌的临床影像学表现及病理分析

Clinical imaging and pathological analysis of collision carcinoma

目的:探讨碰撞癌的临床影像学表现、发病机制与病理特点。方法:回顾性分析20例碰撞癌的临床影像学资料并结合文献复习,总结其患病率、发病年龄、性别比、好发部位、临床影像学表现、治疗手段、病理特点。结果:碰撞癌罕见,好发年龄大于58岁,男性发病多见,好发部位为食管-贲门,食管-胃底等。临床表现无特殊,术前影像学检查多不能明确诊断,术后病理诊断是唯一的确诊方法。治疗以手术为主,辅以化疗或放疗。病理特点为同一宿主同一部位或器官2个不同类型肿瘤的结合,瘤组织间没有移行和混合,有各自的转移途径,碰撞癌以鳞癌和腺癌的碰撞为主。结论:碰撞癌是一种罕见的恶性肿瘤结合,临床特点有待进一步总结,影像学综合诊断有助于提高其确诊率。

Objective： To study the image, pathogenesis and pathological features of collision carcinoma. Methods： Twenty patients were studied retrospectively against the background of literature, including the incidence, age of onset ,sex ratio, predilection sites, clinical signs , image apperence, therapy and pathological features. Results： Collision carcinoma was rare, but more common in males than in females. The peak onset age was more than 58 years . It was found frequently in the esophagus-cardiac part, esophagusfundus of stomach. Absence of special clinical features, it was difficult to diagnose by image inspection before operation. Pathological findings was the only way to make a correct diagnosis. Operation was the ma jor therapy, assisted by chemotherapy and radiotherapy when necessary. Collision carcinoma represented a coexistence of two different malignant neoplasia in an organ. Collision carcinoma was mostly composed of squamous cell carcinoma and adenocarcinoma. Conclusion： Collision carcinoma is rare composed mosaic of malignant tumors. The clinical features of collision carcinoma need further investigatiing, image findings is helpful to increase the rate of correct diagnosis.