早期食道癌の予後

Prognosis of Early Esophageal Cancer

要旨●早期食道癌の転帰と関連するのはリンパ節や他臓器への転移であり，予後不良な早期食道癌はすなわち転移リスクが高いものである．早期食道癌の転移リスクを検討した研究では，リンパ管侵襲は転移と強く関連し，浸潤性の強い浸潤形式や低分化型も転移との関連が示唆された．転移を認めた食道粘膜内癌の症例報告11例では，5例にリンパ管侵襲や浸潤性の強い浸潤形式，低分化型の所見を認めた．一方で残りの6例は，T1a-EP（Tis）/T1a-LPM癌で，脈管侵襲陰性，浸潤形式や分化度に関して特記すべき所見がないにもかかわらず転移を来していた．

　Aggressive early esophageal cancers are cancers with a high metastatic potential, and their outcome is mainly determined by the metastasis. Previous studies have shown that lymphatic invasion, invasive pattern, and poor differentiation are factors associated with metastasis. Among 11 case reports of early esophageal cancer with metastases, 5 had factors such as lymphatic invasion, invasive pattern, or poor differentiation, whereas the other 6 patients with EP/LPM cancers did not have any of these factors.