食管非上皮源性肿瘤的诊断和治疗

Diagnosis and treatment of the esophageal non-epithelial tumors

目的探讨食管非上皮源性肿瘤的诊断和治疗方法。方法收集上海交通大学附属胸科医院胸外科2010年10月—2014年12月间连续收治的70例食管非上皮源性肿瘤患者的临床及病理资料,结合随访情况进行分析。结果食管非上皮源性肿瘤占同期食管肿瘤的3.9%(70/1 783)。70例食管非上皮源性肿瘤患者均行手术治疗,其中66例单纯行食管肿瘤切除术,4例行食管次全切除胃食管吻合术,围术期死亡2例。随访至2017年7月,无失访病例,除3例患者死于肿瘤复发转移外,其余患者均生存良好。结论 (1)食管非上皮源性肿瘤的临床表现无特异性,难以通过临床表现进行诊断,影像学结合食管镜及超声内镜检查可初步判断其起源,明确诊断则须依靠术后病理及免疫组织化学检测。(2)外科手术是其主要的治疗手段,手术方式和径路选择应根据具体肿瘤生物学行为和临床特点而定。

ObjectiveTo explore the principles of diagnosis and treatment of esophageal non epithelial tumors(ENET).MethodsA retrospective study was conducted on70consecutive ENET patients from October2010to December2014in Shanghai Chest Hospital.ResultsENET accounted for3.9%(70/1783)in esophageal tumors during the same period.Among the patients who were treated by surgery,66cases underwent resection of esophageal carcinoma;4cases underwent resection of esophagus and gastric anastomosis;2cases died in perioperative period.Followed up to July2017,no cases were lost,and all cases were survival except3patients who died of tumor recurrence and metastasis.Conclusions(1)It was difficult to make diagnosis for ENET by clinical manifestations because these were not specific.It is helpful to estimate the tumor origin by radiographic,esophageal endoscopy and endoscopic ultrasonography,but definite diagnosis must rely on the postoperative pathology and immunohistochemistry.(2)Surgery was the main method for treatment and surgery style should be carefully taken according to the clinical characteristics and biological behavior of the tumor.