| Background Primary esophageal small cell carcinoma (PESCC) is one kind of malignant tumor characterized in smaller volume derived from epithelial cells of the esophagus. As the case is rare, many reported in the PubMed are case reports, The clinical features, especially the pathological changes and relationship with treatment and prognosis is unclear.Objective In our study, based on laboratory1973-2013years of accumulated340,000cases of esophageal cancer database, learn more about esophageal small cell carcinoma of gender, age and location characteristics, clinicopathological changes, the main clinical treatment methods and their impact on prognosis, provide the basis for prevention and treatment of PESCC. By comparing pre-surgery (biopsy) and the pathological changes in consistency, analysis the initial biopsy diagnosis significance, especially for non-surgical patients, combined with immunohistochemistry detection of tumor protein expression, not only contribute to the differential diagnosis of clinical pathology can also explore its relationship with prognosis according to changes in protein expression associated.Methods1.On the basis of epidemiological investigation, for each patientas many as clinical information was collected based on the retrieved hospital records, including gender, age af diagnosis, TNM staging, morphometric for the gross surgically resected esophageal cancer specimen, tumor size, family history, etc.2. Our study uses multiple immunohistochemistry indicators in28cases of small cell carcinoma of the esophagus joint detection, selection of the seven specific strong indicators, with survival follow-up, to investigate the relationship between tumor protein expression and survival.3. Of183cases of patients who registered clearly home addresses or contact numbers were applied for tracking the conditions of patients by telephone and home interview follow-up. If patients died, the date of death should be identified. The endpoint was death. Until January15,2014,96were successfully followed up, with78deaths and18alive, the success rate is53%.Results1. In183cases, Male/Female=1.35:1, the male’s mean age was59.32±10.24and female’s was60.35±8.84. The tumor location of male (105cases) in the middle segment dominated (78%), followed by the lower thoracic (14%), upper thoracic least (8%); the tumor location of female (78cases) in the middle segment dominated (79%), followed by the upper thoracic (12%), lower thoracic least (9%), gross type of early (17cases) in plaque-based (65%), followed by erosive (35%); advanced (130cases) with ulcerative mainly (61%), followed by medullary (25%), mushroom umbrella again (13%), cavity type at least (1%), without difference between male and female (χ2=0.319, P=0.852). The rate of the regional lymph node metastasis was59%, without difference between male and female (χ2=0.467, P=0.494).2. Immunohistochemistry in28cases, the highest rate of positive CD56(93%), followed by the NES (87%), Syn (87%), CK (67%), CgA (53%), ki-67average of76%positive. Of28cases,22cases follow-up success, its univariate analysis showed that survival of CK-positive indicators than negative significantly longer (χ2=6.729, P=0.009).3. In this study, the median survival time of patients (96cases) was16.8months,5-year survival rate of only15%. Wherein the early1,3,5years survival rates were92%,56%,42%; advanced1,3,5years survival rates were60%,20%,13%. The1,3,5years survival rates were92%,56%and42%. Univariate analysis showed that TNM stage, age, tumor length and treatment were significantly impact on survival (P all<0.05), Cox multivariate regression analysis showed that TNM stage was an independent prognostic factor (P=0.015).Conclusions PESCC is a rare malignant tumor, the first biopsy diagnosis rate is low, easy to metastasis through the lymphatic or blood and has poor prognosis, once diagnosis should be combined radiotherapy and chemotherapy treatment immediately. |
PDF Full Text Request