- 期刊
Primary Adenocarcinoma of the Esophagus
原發性食道腺癌
摘要
食道腫瘤中，扁平上皮細胞癌佔了絕大部份，原發性食道腺癌只佔了其中的一小部份。其發生的來源有三處：1.食道中的異位性骨黏膜，2.食道本身固有的食道腺，3.巴雷氏上皮(Barrett’s epithelium)。台中榮民總醫院從民國七十一年十月至七十九年九月，八年間共治療了450例食道惡性腫瘤的病患。其中只有七例為原發性食道腺癌的病例，佔了食道惡性腫瘤的百分之一點六。此七例病例就其病理特性而言，為腫瘤細胞有較廣泛的黏膜下侵犯，且腫瘤週邊之上皮細胞無分化不良的現象。根據其組織結構，我們認為其發生的來源可能從食道本身固有的食道腺而來的。五例接受外科手術切除的病患中，有四例並無淋巴結轉移的情形。除了一例在手術後六個月因腦中風而死亡以外，其餘三例至今仍存活著，且無腫瘤復發的情形。無淋巴結轉移的原發性食道腺癌如能接受外科手術切除，長期存活的機會仍是相當大的。
關鍵字
無資料並列摘要
From Oct. 1982 to Sep. 1990, 450 cases of tissue proven carcinoma of the esophagus were treated at Taichung Veterans General Hospital, seven of these were primary adenocarcinoma of the esophagus, but only two had been diagnosed pre-operatively (by endoscopy). Most primary lesions may have originated from the submucosal gland for esophagus. The pathological characteristics included submucosal tumor infiltration without dysplasia of epithelium around the tumor margin and absence of Barrentt’s epithelium. Five of the seven patients received surgical resection and four patient showed negative lymph node metastasis. Three long term survival may be expected after surgical resection in node negative primary adenocarcinoma of the esophagus.