CAJ | 학술논문

目的总结食管黏液表皮样癌(MEC)的临床特点、诊断、治疗和预后.方法回顾性分析1991年1月至2010年6月间汕头大学医学院附属肿瘤医院收治的以手术治疗为主的36例食管MEC患者的临床资料,采用Kaplan-Meier法进行生存分析.结果 36例食管MEC患者的临床症状、影像学表现和胃镜下所见与食管鳞癌相似,20例患者术前行胃镜检查,其中18例活检病理误诊为食管鳞癌,2例误诊为腺鳞癌.单纯手术治疗26例,手术加放疗10例.全组患者的中位生存时间为29.0个月,1、2、3和5年生存率分别为80.6％、57.1％、34.4％和25.8％.结论食管MEC罕见,胃镜活检病理易误诊,预后差,手术切除是目前最主要的治疗手段.
목적 총결식관점액표피양암(MEC)적림상특점、진단、치료화예후.방법 회고성분석1991년1월지2010년6월간산두대학의학원부속종류의원수치적이수술치료위주적36례식관MEC환자적림상자료,채용Kaplan-Meier법진행생존분석.결과 36례식관MEC환자적림상증상、영상학표현화위경하소견여식관린암상사,20례환자술전행위경검사,기중18례활검병리오진위식관린암,2례오진위선린암.단순수술치료26례,수술가방료10례.전조환자적중위생존시간위29.0개월,1、2、3화5년생존솔분별위80.6％、57.1％、34.4％화25.8％.결론 식관MEC한견,위경활검병리역오진,예후차,수술절제시목전최주요적치료수단.
Objective To review the clinical characteristics,diagnosis,treatment and prognosis of esophageal mucoepidermoid carcinoma (MEC).Methods Clinical data of 36 patients with pathologically confirmed esophageal MEC who received surgical treatment in Cancer Hospital of Shantou University Medical College from Jan 1991 to Jun 2010 were retrospectively analyzed.The survival analysis was performed using Kaplan-Meier method.Results Of the 4253 patients diagnosed as esophageal cancer during the same time in our center,only 36 had esophageal MEC,accounted for 0.8％.This group included 27 men and 9 women ranging in age from 40 to 78 years ( median 58 years).Esophageal MEC showed similar clinical symptoms,radiological and endoscopic features to esophageal squamous cell carcinoma (ESCC).Of the 20 cases who received preoperatively endoscopic biopsy,18 were misdiagnosed as ESCC and 2 were misdiagnosed as esophageal adenosquamous carcinoma.The mean follow-up duration of this series was 38.8 months (3-142months).22 patients died of the disease during the follow-up period,12 were still alive and 2 were lost of follow-up.The median survival time (MST) of the 36 patients was 29.0 months,and the 1-,2-,3-,and 5-year overall survival rates (OS) were 80.6％,57.1％,34.4％,25.8％,respectively.Conclusions Esophageal MEC is a rare disease and prone to be misdiagnosed by endoscopic biopsy.Surgical resection is the primary treatment but the prognosis is poor.