【摘要】 目的通过分析食管多原发癌的临床病理特征及预后,探讨食管多原发癌的诊断和治疗措施。方法回顾性收集自2000年10月至2008年1月经右胸行En-bloc切除的食管多原发癌患者的临床病理资料和随访结果,分析食管多原发癌的临床病理特点及预后,并结合国内外近年来相关文献,对其诊断和治疗措施进行讨论。结果食管多发癌的发生率为9.6%。8例患者皆为男性,7例吸烟大于20包/d×年,4例嗜酒。病理皆为鳞癌。主癌灶多累及食管全层,次癌灶多为原位癌,部分病例伴有上皮不典型增生。全部患者接受食管癌En-bloc切除及胃食管左颈吻合术。1,3年生存率分别为62.5%和12.5%,中位生存期13个月。结论食管多原发癌的发生是区域癌化的结果;采用Lugol碘液染色下胃镜活检可提高食管多原发癌诊断率;行全食管切除可减少食管癌术后复发率;食管多原发癌发现时多偏晚期,预后较差。更多还原

【Abstract】 Objective To explore the proper diagnostic and therapeutic strategy of multiple primary esophageal carcinomas by analyzing their clinicopathologic features and prognosis.Methods Complete clinicopathologic data of all patients with multiple primary esophageal carcinomas who underwent a transthoracic en-bloc resection from Oct 2000 to Jan 2008 were retrospectively reviewed and analyzed.The proper diagnostic and therapeutic strategy of this disease was discussed by combining our data with literature.Results The incidence of multiple primary esophageal carcinomas was 9.6%.All of the 8 patients were males.Of them 7 were heavy smokers,5 were alcoholics.All the lesions were squamous cell carcinomas.Most of the main lesions invaded adventitia,while most of the secondary primary lesions were carcinoma in situ.Atypical hyperplasia happened in some cases.The 1-year and 3-year survival rates of the group were 62.5% and 12.5% respectively.The median survival time was 13 months.Conclusions The occurrence of multiple primary esophageal carcinomas was due to the field cancerogenesis.Endoscopic biopsy after iodine staining can increase the diagnostic rate of multiple primary esophageal carcinomas.Total esophagectomy can reduce the local recurrence rate after operation.When multiple primary esophageal carcinomas are confirmed,patients are always at the advanced stage,and have poor prognosis.更多还原