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目的：探讨原发性食管小细胞癌伴高分化磷癌的临床病理特点及发生机理。方法：我们收集6例食管小细胞癌伴高分化鳞癌的手术病例进行统计分析。每例做常规染色并采用LSAB法做免疫组化。结果：病灶部位在食管中下段。淋巴结转移6例（100％），合并血道转移5例（83．3％）。本组病例肉眼形态为溃疡型（4例）和息肉型（2例）。镜下观察每例肿瘤均由小细胞癌及高分化鳞癌组成，其中小细胞癌可分为燕麦细胞样小细胞癌（3例）和非燕麦细胞样小细胞癌（3例）。两种肿瘤成分未见移行关系，而高分化鳞癌成分与正常鳞状上皮之间有移行关系。免疫组化显示小细胞癌成分铬粒素（chromograninA，CgA）6例阳性（100％），神经烯醇化酶（NSE）6例阳性（100％）。S－100，白细胞共同抗原（LCA）、细胞角蛋白（CK）均呈阴性，而高分化鳞癌成分CK均呈阳性。结论：食管小细胞癌伴高分化鳞癌是同一肿瘤病灶出现两种不同分化形态及不同免疫表型，而临床上类似食管小细胞癌和起源于食道粘膜上皮恶性程度高的肿瘤，其发生机理有待深入研究。
Objective: To investigate the clinicopathological features and mechanism of primary esophageal small cell carcinoma with highly differentiated P-cancer. Methods: We collected 6 cases of esophageal small cell carcinoma with well-differentiated squamous cell carcinomas for statistical analysis. Routine staining was performed in each case and LSAB was used for immunohistochemistry. Results: The lesion site was in the middle and lower esophagus. Lymph node metastasis occurred in 6 patients (100%), and hematogenous metastasis in 5 patients (83.3%). In this group of cases, the naked eye showed ulcerous (4 cases) and polypoid (2 cases). Microscopically, each tumor was composed of small cell carcinoma and well-differentiated squamous cell carcinoma. Small cell carcinoma can be divided into oat cell-like small cell carcinoma (3 cases) and non-oat cell-like small cell carcinoma (3 cases). There was no transitional relationship between the two tumor components, but there was a transitional relationship between well-differentiated squamous cell carcinoma components and normal squamous epithelium. Immunohistochemistry showed that 6 cases of small cell carcinoma chromogenin A (CgA) were positive (100%) and 6 cases of neuronenolase (NSE) were positive (100%). S-100, leucocyte common antigen (LCA) and cytokeratin (CK) were negative, while well-differentiated squamous cell carcinomas were positive for CK. Conclusions: Small cell carcinoma of the esophagus with well-differentiated squamous cell carcinoma is a tumor with two different differentiated forms and different immunophenotypes. It resembles clinically similar small cell carcinoma of the esophagus and a tumor with a high degree of malignancy originating in the esophageal epithelium. For further study.