特殊組織型の食道癌―病理の立場から：肉眼診断を中心に

Macroscopic Findings of Non-squamous Cell Carcinoma of the Esophagus

要旨　食道の扁平上皮癌（SCC）以外の特殊組織型食道癌の発生頻度は1995～1999年食道癌全国登録切除例9,328例のうち540例（5.8％）で，腺癌1.8％，腺扁平上皮癌，類基底細胞癌，未分化癌などその他特殊型4.0％であった．また1965～2002年の38年間に東京女子医科大学で経験した食道癌切除例では2,498例中141例（5.6％）に特殊組織型癌がみられた．特殊組織型癌は通常のSCCと発生の場が異なり，組織型により隆起型腫瘤や浸潤性発育を示す特色ある肉眼像を呈するものが多い傾向がみられた．特に表在型で切除される症例の増加により，その発生母地が推測できる症例を多く経験した．

　Of 9,328 cases of surgically resected esophageal cancers registered in Japan between 1995 and 1999, 540 cases (5.8 ％) were non-squamous cell carcinoma, including adenocarcinoma (1.8 ％) and other histological types (4.0 ％) (i. e., adenosquamous, basaloid and undifferentiated carcinomas). Among the 2,498 cases of esophageal cancer that were treated surgically at our institution during the past 38 years, we encountered 141 cases (5.6 ％) of non-squamous cell carcinoma. Non-squamous cell carcinoma is different from squamous cell carcinoma in the tissue of origin. In general, each histological type displayed characteristic gross appearance, such as polypoid or sub-epithelial protrusion or infiltrative growth pattern. The recent increase in resected cases of early esophageal cancer has enabled investigation of the initial growth pattern and tissue of origin of the non-squamous cell type.