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目的:探讨原发性食管腺癌的外科治疗经验及其临床生物学特征和影响患者生存期的相关因素。方法:对外科治疗的25例原发性食管腺癌的发病情况、组织来源及治疗方法进行回顾性分析。病理分期:Ⅰ期2例,Ⅱa期2例。Ⅱb期5例,Ⅲ期14例,Ⅳ期2例。根治性手术19例,姑息性手术6例。结果:经手术病理证实的25例腺癌,占同期手术1350例食管癌的1.85%。术后1、3、5年生存率分别为80.4%、36.0%、20.0%,术后并发症发生率为8.0%。结论:食管腺癌和食管鳞癌相比恶性程度高,病变进展快,预后差。影响手术后长期生存的重要因素为TNM分期、有无淋巴结转移、肿瘤外侵程度和手术方式。提高食管腺癌的早期发现率和以外科手术为主的综合治疗是改善术后远期疗效的关键。
Objective: To investigate the surgical treatment of primary esophageal adenocarcinoma and its clinical features and biological factors affecting the survival of patients related factors. Methods: The incidence of surgical treatment of 25 cases of primary esophageal adenocarcinoma, tissue source and treatment were retrospectively analyzed. Pathological staging: Ⅰ in 2 cases, Ⅱ a 2 cases. 5 cases of stage IIb, 14 cases of stage III and 2 cases of stage IV. 19 cases of radical surgery, palliative surgery in 6 cases. Results: 25 cases of adenocarcinoma confirmed by surgery and pathology accounted for 1.85% of 1350 cases of esophageal cancer in the same period. The 1, 3, 5-year survival rates were 80.4%, 36.0% and 20.0% respectively, and the postoperative complication rate was 8.0%. Conclusion: Esophageal adenocarcinoma and esophageal squamous cell carcinoma compared to a high degree of malignancy, rapid progression, poor prognosis. Long-term survival after surgery affect an important factor for TNM staging, with or without lymph node metastasis, tumor invasion and surgical methods. To improve the early detection rate of esophageal adenocarcinoma and surgery-based comprehensive treatment is the key to improve long-term efficacy after surgery.