48例食管粘膜癌及粘膜下癌的临床病理研究

MUCOSAL CARCINOMA AND SUBMUCOSAL CARCINOMA OF THE ESOPHAGUS:A CLINICAL AND PATHOLOGICAL STUDY OF FORTY EIGHT CASES

目的 探讨食管粘膜癌和粘膜下癌的临床病理特征。 方法 对我院１９８０ 年～１９９５ 年间２４ 例粘膜癌和２４ 例粘膜下癌的临床、病理、随访结果进行分析，多因素用ＣＯＸ模型。 结果 粘膜癌和粘膜下癌的３、５ 、１０ 年生存率分别为８７－５％ ，８３－３％ ，８５－７％ 和５８－３ ％ ，４５－５％ ，４５－５％ 。淋巴结转移率分别为４－２％ 和２９－２ ％ 。多因素分析表明：淋巴结转移Ｐ＜０－０１ ，手术切缘阳性Ｐ＜０－０５ ，家族史Ｐ＜０－０５。 结论 粘膜癌和粘膜下癌有不同的预后和生物学行为。淋巴结转移、手术未彻底切除肿瘤。

PURPOSE In order to study the clinicopathologic characteristics of mucosal carcinoma and submucosal carcinoma of the esophagus.METHODS Twenty four patients with mucosal esophageal carcinoma(MEC) and twenty four with submucosal esophageal carcinoma(SUBC) were analyzed clinically,pathologically and by follow up.The predictors were analyzed by Cox proportional regression model.RESULTS The 3 ,5 ,10 year survival rates of MEC were 87.5%,83.3% and 85.7% respectively,and SUBC were 58.3%,45.5% and 45.5% respectively.The lymph node metastases rate of MEC and SUBC were 64.2% and 29.2%.A Cox model analysis showed that lymph node metastases P <0 01,positive margin of resected esophageal lesion P <0 05,family heredity P <0 05.CONCLUSIONS The MEC differs greatly from SUBS with regard to prognosis and biologic behavior.Lymph node metastasis,family heredity,and incomplete excision of the lesion with multiple foci were high risk foctors.