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目的探讨原发性小细胞食管癌的临床特点和适当治疗方法。方法利用１９８６年１月至１９９３年１２月，我院收治的经病理证实的初治小细胞食管癌６９例，回顾性分析其临床特点和治疗方法。结果①临床特点：本病占我院同期食管癌的１．８％，平均发病年龄６０岁，男女比１．５６∶１，疗前自然病程平均１．９月，胸中下段占９２．８％，溃疡型、蕈伞型所占比例明显高于非小细胞食管癌。②生存分析：全组总的中位生存期为１２．７月，１、３、５年生存率分别为５５％、１８％、１２％。放疗、化疗、手术、放化、术化、放术各组的中位生存期分别为：８、７、１１．５、１６、１６．５、１１月。术化和放化综合组的生存率均明显优于各单一治疗组（均Ｐ＜０．０５）。术前放疗不提高生存期。③死亡原因：各组病例的死亡原因均以远处转移为主，转移部位主要为肝、骨、肺、脑、锁骨上及腹膜后淋巴结。结论原发性小细胞食管癌的治疗应以放化或术化综合治疗为主。
Objective To investigate the clinical features and appropriate treatment of primary small cell esophageal cancer. Methods From January 1986 to December 1993, 69 patients with pathologically confirmed primary cell small cell esophageal cancer admitted to our hospital were retrospectively analyzed for their clinical features and treatment. Results 1Clinical characteristics: The disease accounted for 1.8% of esophageal cancer in our hospital at the same period. The average age of onset was 60 years. The ratio of male to female was 1.56:1. The average natural course of disease before treatment was 1.9 months, and the middle and lower thoracic segments accounted for 92.8%. The proportion of ulcers and sputum umbrellas was significantly higher than that of non-small cell esophageal cancer. 2 survival analysis: The overall median survival time of the whole group was 12.7 months, and the 1-, 3-, and 5-year survival rates were 55%, 18%, and 12%, respectively. The median survival time of radiotherapy, chemotherapy, surgery, radiochemotherapy, surgical, and radiotherapy groups was 8, 7, 11.5, 16, 16.5, and 11 months, respectively. The survival rate of the combined surgery and radiotherapy group was significantly better than that of the single treatment group (all P<0.05). Preoperative radiotherapy does not increase survival. 3 Causes of death: The causes of death in all groups were mainly distant metastasis. The metastatic sites were mainly liver, bone, lung, brain, supraclavicular and retroperitoneal lymph nodes. Conclusion The treatment of primary small cell esophageal cancer should be based on radiotherapy or surgical comprehensive treatment.