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有关侵犯上皮,粘膜肌层(MM)或粘膜下层(SM)的表浅型食管癌的外科治疗对策还存在着很多争议.本文作者研究了肿瘤的肉眼形态,肿瘤侵犯的深度和淋巴结转移之间的关系,以确定治疗表浅型食管癌的对策.材料和方法:1979～1992年间共206例原发性胸段食管癌病人在作者所在单位作了食管切除术.其中33例(11%)表浅型食管癌病人作了食管切除和区域淋巴结清扫.3例侵犯上皮,6例侵犯粘膜肌层,24例侵犯粘膜下层.全部病人均作了区域淋巴结清扫,包括食管旁,气管旁,隆凸下,贲门和腹腔淋巴结.清扫淋巴结数为12～67枚,平均26.2枚.根据内窥镜的肉眼所见将肿瘤分成二型:(1)隆起型;(2)扁平或无隆起表现的凹陷型.隆起型肿瘤及分成二型:单纯的隆起型肿瘤(Ⅰ和Ⅱa型),既有隆起又有凹陷表现的肿瘤(Ⅱa十Ⅱc).非隆起型肿瘤亦分成二型:扁平型(Ⅱb型)和单纯凹陷型(Ⅱc和Ⅲ型).根据肿瘤侵犯的深度将MM和SM分成三个类型:MM1指肿瘤侵及粘膜固有层,MM3指肿瘤接近或穿透到粘膜肌层,MM2介于二者之间.SM1指肿瘤穿透粘
There are still many controversies regarding the surgical treatment of superficial esophageal cancers that invade the epithelium, mucosal muscularis (MM), or submucosa (SM). The authors studied the macroscopic morphology of tumors, the depth of tumor invasion, and lymph node metastasis. The relationship to determine the treatment of superficial esophageal cancer countermeasures. Materials and Methods: A total of 206 primary thoracic esophageal cancer patients underwent esophageal resection in the author’s unit between 1979 and 1992. Among them, 33 (11%) Esophageal resection and regional lymph node dissection were performed on patients with superficial esophageal cancer. Three cases invaded the epithelium, six cases invaded mucosal muscularis, and 24 cases invaded the submucosa. All patients underwent regional lymph node dissection, including paraesophagus, paratracheal tube, and long tuberculosis. Under the convex, cardiac and abdominal lymph nodes, the number of lymph nodes was 12 to 67, averaging 26.2. According to the naked eye, the tumor was divided into two types: (1) uplift type; (2) flat or no bulging performance. Depressed and uplifted tumors are divided into two types: simple uplift tumors (types I and IIa), tumors with both uplift and depression (IIa and II IIc). Non-uplift tumors are also divided into type II: flat ( IIb) and simple depression (IIc and III). According to swollen The depth of invasion MM and SM into three types: MM1 refers to tumor invasion and lamina propria, MM3 a tumor close to or penetrating into muscularis mucosa, MM2 .SM1 means interposed therebetween tumor penetration sticky