原发性食管小细胞未分化癌(附15例分析)

Primary Small Cell Undifferentiated Carcinoma of the Esophagus. Report of 15 Cases

本文分析原发性食管小细胞未分化癌15例,发生率占同期收治食管癌2121例的0.71％。本病主要见于中老年男性,中位年龄57岁,男性11例,女性4例。吞咽困难是最常见的症状,中位症状期2个月。食管上段1例,中段8例,下段6例。溃疡型6例,髓质型5例,缩窄型3例,蕈伞型1例。病灶长3.5cm～10cm,平均6.0cm。单纯小细胞癌型13例,混合鳞癌型1例,双重癌1例。15例中手术探查12例,其中切除7例,短路2例,单纯探查术3例。12例均给予辅助化疗,选用CCOM方案。放疗加化疗1例,单纯化疗2例。15例均随访,13例死亡,1例失访,1例尚在治疗中。14例中位生存期7个月。手术切除加化疗组7例中,2例最长生存20个月,中位生存期11个月。手术切除加辅助化疗,略优于其它治疗组。

Fifteen cases of primary small cell undifferentiated carcinoma of the esophagus are reported. The incidence rate was 0. 71 % of 2121 carcinomas of the esophagus in this hospital. Eleven tumors occurred in male and four in female. Age ranged from 40 to 72 years. Dysphagia was the most common symptom and was found in 11 cases. One tumor arose in the upper third of the esophagus,eight in the middle third and six in the lower third. The tumor was medullary in 5 cases, ulcerating in 6,stenotic in 3 and fungating in 1. Thirteen tumors were of the small cell carcinoma,one of which mixed with squamous cell and another mixed with adenocarcinoma of the cardia in lower third of the esophagus. Seven cases were esophagectomized in association with adjuvant chemotherapy,two of which survived for as long as 20 months with mean survival 11 months.