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目的:通过分析同时性食管贲门双原发癌漏误诊原因,探讨提高术前诊断率的方法。方法:对我院1998年1月至2006年12月收治的同时性食管贲门双原发癌11例病人的临床资料进行回顾性研究。结果:11例病人中食管上段贲门双原发癌2例,食管中段贲门双原发癌7例,食管下段贲门双原发癌2例。食管病变均为鳞癌,贲门病变腺癌10例,鳞癌1例。术前诊断主要通过上消化道造影、胃镜和胃超声检查完成,术前确诊食管贲门双原发癌5例,诊断率45%。结论:提高食管贲门双原发癌的术前诊断率关键是要把上消化道造影和胃镜检查有机结合起来,胃超声检查能有效发现贲门病变。
Objective: To analyze the reason of misdiagnosis of simultaneous esophageal and cardial double primary esophageal carcinoma in order to improve the preoperative diagnosis rate. Methods: The clinical data of 11 patients with concurrent primary esophageal and cardiac cardia cancer treated in our hospital from January 1998 to December 2006 were retrospectively studied. Results: Among the 11 patients, there were 2 cases of primary esophageal carcinoma in the upper esophagus, 7 cases of double primary esophageal carcinoma in the esophagus, 2 cases of double primary esophageal carcinoma in the lower esophagus. Esophageal lesions were squamous cell carcinoma, cardiac adenocarcinoma in 10 cases, squamous cell carcinoma in 1 case. Preoperative diagnosis mainly through the upper gastrointestinal imaging, endoscopy and gastric ultrasound, preoperative diagnosis of esophageal and cardial double primary cancer in 5 cases, the diagnosis rate of 45%. Conclusion: The key to improve the preoperative diagnosis of esophageal and cardial double primary cancer is to organically combine upper gastrointestinal imaging with gastroscopy. Gastric ultrasonography can effectively detect cardia lesions.