同时性多发早期食管癌和上皮内瘤变主病灶与副病灶临床病理特征的比较

Comparison of clinicopathological characteristics of main and accessory lesions in patients with synchronous multiple early esophageal cancer and intraepithelial neoplasia

摘要:

目的 比较同时性多发食管病变(SMEL,包括食管早癌和上皮内瘤变)主副病灶的临床病理特点,并探讨其关联性。方法 回顾性分析2006年11月至2019年9月于中国人民解放军总医院第一医院中心接受内镜治疗的80例SMEL患者,总结患者临床病理特点。并将病灶分为主病灶和副病灶,探讨主副病灶在内镜分型、病变位置,病理类型和浸润深度等方面的关联程度。结果 研究纳入的 80 例多发性 SMEL患者平均年龄为61.3±8.32)岁,男性多见(83.8％,67／80)。有吸烟和饮酒史的均为57例(71.2%)。主病灶和副病灶的直径存在正相关(r＝0. 4644,P<0. 001)。主、副病灶的内镜形态(P=0.115)、病变位置(P=0.340)及浸润深度(P=0.555)不具有一致性,但病理类型具有较高的一致性(P＜0.001)和匹配度(50.0%)。结论 多数SMEL患者为有吸烟史和饮酒史的老年男性患者,在发现一个病灶时,应警惕多发病在存在可能,并注意主次病灶之间关联性,避免漏诊。

Abstract:

Objective To compare the clinicopathological characteristicsof main and accessory lesions in patients with synchronous multiple esophageal lesions (SMEL, including esophageal early cancer and intraepithelial neoplasia) and to explore their correlation. Methods 80 Patients with SMEL treated by endoscopic resection in the First Center of Chinese PLA General Hospital from November 2006 to September 2019 were retrospectively analyzed, and the clinicopathological characteristics of the patients were summarized. Then the lesions were divided into main lesions and accessory lesions, and the correlation of main and accessory lesions inmacroscopic type, lesion location, pathological type and invasion depth were investigated. Results the average age of 80 patients with SMEL included in the study was 61.3 ±8.32 years old, which was more common in males (83.8%). 57 patients (71.2%) had a history of smoking and drinking. There was a positive correlation between the size of main lesions and accessory lesions (r=0.4644, P<0.009). The macroscopic type (P=0.115), location (P=0.340)and depth of invasion (P=0.555) of the main and accessory lesions were not correlate, but the pathological types had high correlation (P<0.001) and matching degree (50.0%). Conclusions Most SMEL patients are elderly male patients with a history of smoking and drinking. When one lesion is found, the possibility of multiple lesions and the correlation between main and accessory lesions should be paid attention to avoid missed diagnosis.