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目的：依据食管癌肉瘤的临床、病理特点，探讨其可能的组织学来源。方法：对１４例食管癌肉瘤病人的临床资料进行了回顾性研究。结果：食管癌肉瘤多为息肉样腔内生长，有细短蒂和食管壁相连，个别呈浸润生长。光镜下肉瘤与癌两种成分共存，瘤体多以肉瘤成分为主，癌多局限于蒂的基底部，且多为早期鳞癌。１４例患者无１例肿瘤外侵。淋巴结转移率２１．４％，手术切除率１００％。术后１、３、５、１０年生存率分别为８５．７％、７５．０％、５８．３％和３７．５％。结论：食管癌肉瘤是一种侵袭性差，淋巴结转移率低，预后较佳的肿瘤。手术切除是其首选和主要的治疗手段。其组织学来源可能是食管粘膜的多潜能原始干细胞。
Objective: To investigate the possible histological origin of esophageal carcinosarcoma based on its clinical and pathological features. Methods: Retrospective study was performed on the clinical data of 14 patients with esophageal carcinosarcoma. RESULTS: Esophageal carcinoma sarcoma grew mostly in polyps, with short pedicles connected to the esophageal wall and infiltrating in individual growth. Under light microscopy, sarcoma and cancer have two components coexisting. The majority of tumors are composed of sarcoma components. The cancer is mostly confined to the base of the pedicle, and most of them are early squamous cell carcinomas. None of the 14 patients had tumor invasion. The lymph node metastasis rate was 21.4% and the surgical resection rate was 100%. The 1-, 3-, 5-, and 10-year survival rates were 85.7%, 75.0%, 58.3%, and 37.5%, respectively. Conclusion: Esophageal carcinosarcoma is a tumor with poor aggressiveness, low lymph node metastasis and better prognosis. Surgical resection is its preferred and primary treatment. Its histological source may be pluripotent primitive stem cells of the esophageal mucosa.