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1973～1983年间诊断为至少有3 cm长一段柱状上皮粘膜食管89例中,发现22例患有腺癌。良性组与腺癌组之间在性别、吸烟、饮酒等方面无差异。其差异在:腺癌组病人年龄偏大、吞咽困难、胃肠道出血、柱状上皮粘膜向食管近端延伸,以及上皮化生的情况较良性组多。而食管烧灼感比良性组少。但一旦出现症状,其生存期限长(平均18.8年)。观察了两例良性柱状上皮粘膜食管转变为早期腺癌的进展过程。腺癌病人中2例未做手术,经保守治疗分别死于4个月和9个月。6例行食管胃部分切除,一例术后死亡,4例在手术切缘仍有柱状上皮粘膜残留,其中一例发生狭窄,一例吻合口腺癌复发,一年生存率为50%。14例行全胸段食管切除,无一例死亡,狭窄或吻合口处复发。一年生存率为5/6,外科病变分级63%病变穿透食管壁,55%有淋巴转移。
Between 1973 and 1983, 89 patients with at least 3 cm column epithelial mucosal esophagus were diagnosed and 22 were found to have adenocarcinoma. There was no difference in gender, smoking, alcohol consumption between the benign group and the adenocarcinoma group. The differences were: older patients with adenocarcinoma, dysphagia, gastrointestinal bleeding, proximal epithelial elongation of the columnar epithelium, and epithelial metaplasia were more frequent than those in the benign group. The esophageal burning sensation was less than that of the benign group. However, once the symptoms appear, their survival period is long (average 18.8 years). Observed two cases of benign columnar epithelial mucosal esophageal transition to early adenocarcinoma progress. Two of the adenocarcinoma patients had no surgery and died of conservative treatment for 4 months and 9 months, respectively. Six patients underwent partial esophagogastric resection and one patient died after surgery. Four patients still had residual columnar epithelium at the surgical incision margin. One patient had a stenosis. One patient had anastomotic recurrence of adenocarcinoma, and the one-year survival rate was 50%. Fourteen patients underwent total thoracic esophagectomy and no death occurred. There was a recurrence of stenosis or anastomotic leakage. The one-year survival rate was 5/6. Surgical lesions were graded with 63% of the lesions penetrating the esophagus wall and 55% with lymphatic metastases.