2015 年第 1 期 第 13 卷

51例食管基底细胞样鳞癌外科治疗及预后

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关键词：食管肿瘤，基底细胞样鳞癌，手术，预后

• 摘要：
• 【摘要】目的：食管基底细胞样鳞癌（BSCCE）是一类少见的具有独特病理特征的鳞癌亚型，本研究旨在探讨该病的临床特征及预后。 方法：回顾性分析中国医学科学院肿瘤医院1999年3月至2004年12月手术治疗的51例食管基底细胞样鳞癌患者的临床资料,并与同期手术的食管低分化鳞癌进行生存比较。结果：51例患者中，包括I期5例，II期28例，III期18例。全组35例患者行胃镜检查，其中仅4例（11.5%）诊断为基底细胞样癌。全组BSCCE患者中位生存时间（MST）为 31月，1年、3年、5年总生存率（OS）分别为81.6%、45.9%、29.5%，与典型食管低分化鳞癌的MST 32.5月，1年，3年，5年生存率76.1%、47.8%、32.4%相近（P=0.821）。Cox多因素分析显示，肿瘤部位、病理TNM分期均是影响BSCCE手术预后的独立因素。结论：该病恶性程度高，其预后与食管低分化鳞癌相近。手术切除在明确诊断的同时起到治疗的作用，因而值得推荐。
• Objective: Basaloid squamous cell carcinoma of the esophagus(BSCCE) is a rare and distinct pathological variant of squamous cell carcinoma, the aim of the study was to investigate the clinical characteristics and treatment modalities of this disease. Methods: The clinical data of 51 patients with BSCCE that received surgical treatment in the Cancer Hospital and Institute, Chinese Academy of Medical Sciences, from March 1999 to December 2004 were retrospectively analyzed . The long-term survival of BSCCE was compared with that of poorly differentiated squamous cell carcinoma of the esophagus (PSCC) treated in our hospital in the same period. Results: For the entire group, there were 5 patients in stage I, 28 patients in stage Ⅱ, 18 patients in stage Ⅲ included. Among 35 patients received endoscopic biopsy, only 4 cases were diagnosed with BSCCE. The median survival time (MST) of BSCCE was 31 months and the 1-,3- and 5-year overall survival rates (OS) were 81.6%, 45.9%, and 29.5%, respectively, while the MST of PSCC was 32.5 months, 1-,3- and 5-year OS were 76.1%, 47.8%, 32.4%, respectively(P=0.821). In Cox’s multivariate analysis, the tumor location and pathological TNM stage were found to be independent prognostic factors. Conclusion: Basaloid squamous cell carcinoma is an aggressive disease with poor prognosis close to that of PSCC. Surgical resection, which could help to make a defenitive diagnosis and achieve radical resection, should be recommended. Key words: Esophageal cancer; Basaloid Squamous Cell Carcinoma; Surgery; Prognosis;