7例食管癌肉瘤临床病理分析

The Clinicopathological Observation on 7 Cases with Esophageal Sarcomatoid Carcinoma

目的探讨食管癌肉瘤的临床病理特点、诊断、鉴别诊断及生物学行为。方法回顾7例食管癌肉瘤的临床病理资料,采用HE、免疫组织化学检测,结合文献进行分析,并对其随访。结果食管癌肉瘤多见于中老年男性,肿瘤多位于食管中下段,呈息肉样,有短蒂与食管壁相连,突向腔内。镜下癌与肉瘤两种成份共存。免疫组化示:癌成份Keratin(++),其中2例癌细胞Vimetin(+);肉瘤成份Vimetin(++),其中2例Keratin(+)。结论食管癌肉瘤是具有癌和肉瘤两种成份的恶性肿瘤,其恶性程度较低,其组织来源可能是同一干细胞。

Objective To explore the clinicopathological features, the diagnoses, differential diagnoses and biological beheaviors of esopha- geal sarcomatoid carcinoma（SC）. Methods The clinical and pathological data of 7 cases with the esophageal SC were analyzed retrospec- tively by HE and by immunohistochemistry. All the cases had been investigated after treatment. Results Esophageal sarcomatoid carcinoma mainly occurred in adult males. Esophageal sarcomatoid carcinomas were usually at inferior or middle esophagus, and the tumors showed poly- pus in shape and protruded into the lumen of the esophagus with a short narrow pedicle. Microscopically, both carcinomatous and sarcoma- tous components were seen and transited each other. Immunohistochemically, the carcinomatous elements were positive for Keratin and Vime- tin. The tumor elements were positive for Keratin in 2 cases and for Vimetin protein in the partial tumor cells in 2 cases. Conclusion The esophageal SC is a lowly malignant tumor that composed two types of cell（ carcinomatous and sarcomatous tumors）. The double phcnotypes of the tumors may result from the stem cell transforming to muhidirection.