食管癌肉瘤14例

Carcinosarcoma of the Esophagus(Report of 14 Cases)

目的：依据食管癌肉瘤的临床、病理特点，探讨其可能的组织学来源。方法：对１４例食管癌肉瘤病人的临床资料进行了回顾性研究。结果：食管癌肉瘤多为息肉样腔内生长，有细短蒂和食管壁相连，个别呈浸润生长。光镜下肉瘤与癌两种成分共存，瘤体多以肉瘤成分为主，癌多局限于蒂的基底部，且多为早期鳞癌。１４例患者无１例肿瘤外侵。淋巴结转移率２１．４％，手术切除率１００％。术后１、３、５、１０年生存率分别为８５．７％、７５．０％、５８．３％和３７．５％。结论：食管癌肉瘤是一种侵袭性差，淋巴结转移率低，预后较佳的肿瘤。手术切除是其首选和主要的治疗手段。其组织学来源可能是食管粘膜的多潜能原始干细胞。

Objective:To evaluate the clinical and pathological characteristics of esophageal carcinosarcoma.Method The clinical materials of 14 patients with carcinosarcoma were retrospectively sutdied.Result:Grossly most of the tumors were ploypoid in shape and protruded into the lumen of the esophagus with a short narrow pedicle.Microscopically the tumors were composed of both carcinomatous and sarcomatous elements.Usually the sarcomatous element formed the bulk of the lesion and the carcinomatous element located at the base of the pedicle with the feature of early squamous cell carcinoma.None of 14 cases was extraextension direct invasion observed.The lymph node metastasis rate was 21.4%.The resectability rate was 100%.The 1 year,3 year,5 year and 10 year survival rates were 87.5%,75%,58.3% and 37.5%,respectively.Conclusion:Esophageal carcinosarcoma is an independent entity with little invasiveness,low lymph node metastasis and good prognosis.Surgical resection is the first preferrable and main treatment.Both carcinomatous and sarcomatous elements may have their origins from the same pluripotent stem cell of esophageal mucosa.