122例早期食管癌的临床和病理分析

Early esophageal cancer:clinicalpathology characteristics of 122 cases

目的 探讨早期食管癌的临床及病理特点，提高早期食管癌的诊断率。方法回顾性分析该院2004～2008年5年间经术后病理证实的122例早期食管癌和同期1215例中晚期食管癌患者的临床病理资料。结果早期食管癌男性多见（78．69％，96／122）；好发年龄为50—69岁；好发于食管中段（79．51％，97／122）；粘膜下癌占多数（61．47％，75／122）；鳞癌占98．36％（120／122）；25．41％（31／122）因非食管症状就诊；糜烂型和斑块型各为45％、35％。早期食管癌与中晚期食管癌在性别、年龄段、发生部位方面均无显著性差异（P〉0．05）。早期食管癌胃镜下9例充血型病例均证实为原位癌，黏膜内癌中糜烂型为62．96％，黏膜下癌中斑块型为44．44％。早期食管癌胃镜下分型与其术后浸润深度有明显的相关性（P〈0．01）。结论早期食管癌胃镜下以糜烂型和斑块型为主。胃镜检查是发现早期食管癌的重要方法，且有助于肿瘤浸润深度的估计，重视胃镜下食管检查。

Aim To study clinicalpathology characteristics was made of the early esophageal cancer（ EEC ） and raise the diagnosis rate of it. Methods A retrospective analysis was made the 122 cases of the EEC and 1215 cases of accompanying EC in the mid-late stage which proved by operation from 2004 to 2008 in our hospital. Results 78.69% of the patients of EEC were males and ranged in age from 50 to 69 years. 79.51% of the EEC was in middle part-oriented,61.47% of which was submueosal carcinoma. 98.36% of its path- ological type was squamous carcinoma. 25.41% of patients go to hospital not because of the esophageal symptoms. The ratio of the erosive type and the block type were 45% and 35% ,respectively. There was no difference between them in sex, age and location of the tumor（ P 〉 0.05 ）. 90% of the hyperaemia type of the EEC was the carcinoma in situ. The percent of the erosive type in mucous cancer was 62. 96%. 44.44% of the submueosal carcinoma was the block type. Correlation is obvious between the type and size of pathology under gastroscopy and the depth of infiltration . Conclusion The erosive type and the block type were the main type of the EEC. An important method of early detection of the EEC was gastroscope inspection. Moreover, it will contribute to evaluating the depth of the tumour. We should pay attention to the patients which dont have esophageal symptoms.