【作者】 李保庆； 张云杰； 李作生； 李勇； 张月峰； 刘俊峰； 王福顺； 田子强；

【Author】 Li Bao-Qing Zhang Yun-Jie Li Zuo-Sheng et al Department of Thoracic Surgery, The Fourth Hospital of Hebei medical university & Hebei provincial tumor hospital, Shijiazhuang, 050011, China

【机构】 河北医科大学第四医院暨河北省肿瘤医院胸外科；

【摘要】 目的:探讨食管、贲门小细胞癌的临床特征及探讨影响预后的因素,指导和改善治疗现状。方法:对河北医科大学第四医院自1996年5月至2006年5月十年间手术的203例食管、贲门小细胞癌的资料进行回顾性报告和分析。本组203 例食管、贲门小细胞癌中,男138例,女65例,男:女约为 2．12:1。年龄38～76岁,平均年龄61岁。其中,食管小细胞癌13l例(男81例,女50例)。贲门小细胞癌72例(男57 例,女15例)。结果:本组203例食管、贲门小细胞癌均行手术切除,占同期食管、贲门癌手术的0．95％(203／21400)。术前确诊率为32．7％;全组手术切除率100％;2例误诊为平滑肌瘤,因其X线表现酷似平滑肌瘤。未出现手术死亡和术后严重并发症,均痊愈出院。已完成的随访结果显示(失访按死亡计算)总的1、3年生存率分别为:61．2％、5．6％,目前有1例生存期满10年,仍健在。结论:食管、贲门小细胞癌是一种恶性度高的少见肿瘤,预后差;其临床表现、X线征象等与食管鳞癌、贲门腺癌相似,但生物学行为及治疗原则等则与食管鳞癌及贲门腺癌有显著区别,不但恶性程度高,易发生转移,而且治疗效果不佳,中位生存期为6个月左右。作者所在单位自1952年到2006年54年间,共行食管和贲门癌手术21400例。20世纪80年代以前仅遇到食管和贲门小细胞癌不足10例,近年来诊断治疗了203例,说明小细胞食管和贲门癌有升高的趋势。治疗方法局限,即I和II期患者,应以手术为主,同时辅以化疗或放疗,结合中药免疫治疗等综合治疗;广泛期应采用以个体化化疗辅以放疗、中药、免疫等为主要措施的综合治疗,以提高其生存率,改善预后。本组有1例II期患者已存活10年仍健在。对于食管、贲门小细胞癌应抓“三早”,即早期发现、早期诊断和早期治疗,改善治疗现状。更多还原

【Abstract】 Objective: To discuss the clinical characteristic for small cell carcinoma of the esopohagus and the gastric cardia and to evaluate the prognostic factors in the patients with small cell carcinoma of the esopohagus and the gastric cardia.To coach and improve actuality of treatment. Methods: During 5/1996 to 5/2006, the 203 cases of small cell carcinoma of the esopohagus and the gastric cardia were operated. A clinical review and analy- sis was performed for the 203 cases. Thereinto, male 138 case, female 65 case. The ratio of male to female was 2.12 to 1. Age 38-76 years. Average 61 years. Thereinto, the 131 cases of small cell carcinoma of the esophagus, the 72 cases of small cell carcinoma of the gastric cardia. Results: The 203 case of small cell carcinoma of the esopohagus and the gastric cardia were operated. The small cell carcinoma of the esopohagus and the gastric cardia accounted for 0.95% (203/21400) in the same period patients of the esopohagus and the gastric cardia. Diagnosis rate of preceding operation 32.7%. Whole set the surgical excision rate 100%. 2 misdiagnosises is smooth muscle lumps. DO not appear the surgical operation death and other serious complications. all completely recovered hospital discharge. Accomplished with visit the result manifestation(Iose to visit to press the death calculation) total of 1 and 3 years existence rate respectively is:61.2%,5.6%, have one case existence period expires for 10 years currently, still living. Conclusion: The small cell carcinoma of the esopohagus and the gastric cardia is a kind of high and seldom seen tumor, prognostic bad behind; Its clinic performance,X line sign etc, and the esophagus squama cancer, the gastric cardia gland cancer likeness, but the biology behavior and the treatment principle classes and grades and the esophagus squama cancer and gastric cardia gland cancer have already shown differentiation, not only malignant degree is high, the easy occurrence transfer, and the treatment is ineffective, medium the existence expect to be for 6 about months.Author the place unit from 1952-2006 years during 54 years, the esophagus and gastric cardia carcinoma surgical operation is 21400.Met small cell carcinoma of the esopohagus and the gastric cardia were no more than 10 cases only 80’s in 20 centuries ago, recent years 203 case, explain the trend that went up. Cure the method limit, namely the I and II expect a sufferer, should regard surgical operation as principle, assisting with the chemotherapy or radiation treatment in the meantime, combining the Chinese herbal medicine immunity treatment etc. is comprehensive to cure, Expecting extensively should adopt to be assist with the individuation chemotherapy to radiation treatment, Chinese herbal medicine, immunity...etc. as main measure of comprehensive cure to raise its existence rate, the improvement prognosis. This set has 1 II to expect a sufferer to have already survived 10 years still living. Should grasp"three更多还原