中国癌症杂志 ›› 2020, Vol. 30 ›› Issue (8): 626-631.doi: 10.19401/j.cnki.1007-3639.2020.08.010

• 论著 • 上一篇    下一篇

胃镜检查在下咽癌共病食管癌中的重要性评价及其临床特点分析

唐曦平,刘爱群,刘立义,黄月丽   

  1. 广西医科大学附属肿瘤医院内镜中心,广西 南宁 530021
  • 出版日期:2020-08-30 发布日期:2020-09-04
  • 通信作者: 唐曦平 E-mail: tangxiping108@hotmail.com
  • 基金资助:
    广西高校中青年基础能力提升项目(2018KY0125);广西卫生厅立项项目(Z2015546)。

Evaluation of the importance of gastroscopy and analysis of clinical characteristics in hypopharyngeal carcinoma comorbid with esophageal cancer

TANG Xiping, LIU Aiqun, LIU Liyi, HUANG Yueli   

  1. Department of Endoscopy Center, Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • Published:2020-08-30 Online:2020-09-04
  • Contact: TANG Xiping E-mail: tangxiping108@hotmail.com

摘要: 背景与目的:食管癌是常见的消化道恶性肿瘤,而当作为头颈部鳞癌中最常见的下咽癌与食管癌共病存在时预后很差,因此早期诊断对该病生存率的提高至关重要。探讨胃镜检查在下咽癌共病食管癌早期诊断中的重要性及其临床特点。方法:在2013年2月—2019年9月广西医科大学附属肿瘤医院收治的226例下咽癌患者中,回顾性分析40例进行了胃镜检查患者的临床资料及确诊为下咽癌共病食管癌患者的临床特点,比较分析进行或未进行胃镜检查下咽癌患者的生存率。结果:226例下咽癌患者中,有40例(17.7%)进行了胃镜检查,其中检出下咽癌共病食管癌36例(90.0%),其中同时性癌29例(80.6%),异时性癌7例(19.4%)。36例下咽癌共病食管癌患者中位年龄56.5(47.3~62.5)岁,男性32例(88.9%),有吸烟史25例(69.4%),有饮酒史24例(66.7%),下咽癌生长的主体部位在梨状窝区的23例(63.9%),呈结节样肿块型25例(69.4%),食管癌呈隆起型病变31例(86.1%),非隆起型病变5例,其中3例为食管鳞癌,2例为原位癌。156例未进行胃镜检查及32例进行胃镜检查的下咽癌患者生存曲线比较差异无统计学意义(P>0.05)。186例未进行胃镜检查及40例进行胃镜检查的下咽癌患者下咽癌病理学分化程度比较差异无统计学意义(P>0.05)。结论:胃镜检查在下咽癌共病食管癌的早期诊断中具有重要意义,建议对下咽癌患者常规开展胃镜检查并作为定期随访项目;中年、男性、吸烟、饮酒是下咽癌共病食管癌患者的重要临床特点。

关键词: 下咽癌, 食管癌, 胃镜, 临床特点

Abstract: Background and purpose: Esophageal cancer is common malignant tumor of digestive system. The prognosis of hypopharyngeal carcinoma, the most common type of squamous cell carcinoma of the head and neck, comorbid with esophageal cancer is poor. Therefore, early diagnosis is critical to improving survival. The purpose of this study was to investigate the importance of gastroscopy in the early diagnosis of hypopharyngeal carcinoma comorbid with esophageal cancer and its clinical characteristics. Methods: Of the 226 patients with hypopharyngeal carcinoma in Tumor Hospital of Guangxi Medical University from Feb. 2013 to Sep. 2019, the clinical data of 40 patients who underwent gastroscopy and the clinical characteristics of patients with hypopharyngeal carcinoma comorbid with esophageal cancer were retrospectively analyzed. Then, we compared and analyzed the survival rate of patients with hypopharyngeal carcinoma with or without gastroscopy. Results: Of the 226 patients with hypopharyngeal carcinoma, 40 patients (17.7%) underwent gastroscopy. Among them, 36 cases were diagnosed as hypopharyngeal carcinoma comorbid with esophageal cancer (90.0%), including 29 cases of synchronous cancers (80.6%) and 7 cases of metachronous cancers (19.4%). The median age of these 36 patients was 56.5 (47.3, 62.5) years. Among them, there were 32 males (88.9%), 25 cases with a history of smoking (69.4%), 24 cases with a history of drinking (66.7%), 23 cases with tumor in piriform fossa (63.9%) and 25 cases of nodular masses (69.4%). Thirty-one cases of esophageal cancer showed raised lesions (86.1%), and 5 cases had lesions without elevation, of which 3 were esophageal squamous cell carcinoma and 2 were carcinoma in situ. There was no statistically significant difference in the survival curves between 156 patients without gastroscopy and 32 patients with gastroscopy (P>0.05). There was no statistically significant difference in the pathological differentiation of hypopharyngeal cancer between 186 patients without gastroscopy and 40 patients with gastroscopy (P>0.05). Conclusion: Gastroscopy is important in the early diagnosis of hypopharyngeal carcinoma comorbid with esophageal cancer. Therefore, routine examination and follow-up gastroscopy in patients with hypopharyngeal carcinoma are recommended. The important clinical features of patients with hypopharyngeal carcinoma comorbid with esophageal cancer include middle age, male, smoking and drinking, which provide a basis for early clinical targeted intervention.

Key words: Hypopharyngeal carcinoma, Esophageal cancer, Gastroscopy, Clinical features