原发性食管腺癌(附36例分析)

Primary Esophageal Adenocarcinoma:Analys of 36 Cases

目的：总结原发性食管腺癌（PEAC）的外科治疗经验，探讨其临床生物学特征及影响患者生存期的相关因素。方法：对外科治疗的36例患者进行回顾性分析。结果：36例PEAC占同期手术病理证实1 613例食管癌的2．2％。按1997年新的国际食管癌TNM分期标准，Ⅰ期3例，Ⅱa期14例，Ⅱb期8例，Ⅲ期11例。手术后5年生存率分别为100％，37．5％，16．7％，0（P＜0．01），其总的术后5年生存率为26．9％。手术5年后死于转移癌占77．8％。结论：PEAC恶性程度高，预后差。影响PEAC手术后长期生存率的重要因素为TNM分期、有无淋巴结转移、肿瘤外侵程度和手术方式。提高早期PEAC的发现率和以外科手术为主的综合治疗是改善术后远期疗效的关键。

Objective To summarize the experience in surgical treatment of primary esophageal adenocarcinoma PEAC and to investigate the clinical biocharacteristics and factors influencing patients＇ survival． Methods Thirty－six cases of PEAC undergone surgical treatment were analysed retrospectively． Results Thirty－six cases of PEAC consisted of 2．2％ of 1 613 cases of pathologically confirmed esophageal carcinoma． According to The New TNM Classfication in Esophageal Carcinoma 1997.3 cases were in stage I.14 cases in stage ⅡA.8 cases in stage ⅡB and 11 cases in stage Ⅲ． The 5－year survival rates of them were 100．0％.37．5％.16．7％ and 0％ respectively P＜0．01． The overall 5－year survival survival rate of PEAC was 26．9％． Metastasis remained to be the cause of death in 77．8％ of patients who lived longer than 5 years． Conclusion PEAC is a malgnant disease with poor prognosis． The TNM staging.lymph node metastasis.extraesophageal extension of the primary tumor and mode of operation are the important influencing factors in the long－term survivals． The long－term survival may be increased by early detection of PEAC.early surgical intervention and adjunct multi－modality treatment．