食管肉瘤樣癌診治現狀_West China Medical Journal

Authors：

印金平 ,  彭楓

四川大學華西醫院胸部腫瘤科（成都 610041）;

Corresponding?author：

彭楓, Email: pfwork@126.com

Keywords：

食管肉瘤樣癌; 食管腫瘤; 肉瘤樣癌; 手術治療; 放射治療; 化學療法

DOI：

10.7507/1002-0179.201612111

Video：

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Abstract Full text Figures/Tables Video References Cited by

食管肉瘤樣癌是一種十分罕見的食管惡性腫瘤，無特異性臨床癥狀及體征，主要表現為吞咽梗阻、胸骨后疼痛等；其生長速度較快，常呈息肉樣生長；具有上皮性癌和梭性肉瘤樣細胞 2 種成分，并以肉瘤樣成分占優勢，其發病原因及病理組織起源目前尚未明確；免疫組織化學檢測癌成分常見細胞角蛋白及上皮膜抗原表達，肉瘤樣成分常見波形纖維蛋白表達；治療方式以手術為主，對放射治療、化學療法（化療）較敏感，常用化療方案為鉑類聯合氟尿嘧啶類或紫杉類的雙藥聯合方案，其早期預后較食管鱗狀細胞癌好。

Citation： 印金平, 彭楓. 食管肉瘤樣癌診治現狀. West China Medical Journal, 2017, 32(11): 1814-1817. doi: 10.7507/1002-0179.201612111 Copy

1.	丁華野, 廖松林. 癌肉瘤和肉瘤樣癌. 診斷病理學雜志, 1999(1): 60-61.
2.	方銑華, 林雪平. 肉瘤樣癌及癌肉瘤的新認識. 腫瘤研究與臨床, 2005, 17(2): 138-139.
3.	Raza MA, Mazzara PF. Sarcomatoid carcinoma of esophagus. Arch Pathol Lab Med, 2011, 135(7): 945-948.
4.	焦亮, 王涌泉. 腎肉瘤樣癌研究進展. 臨床與病理雜志, 2016, 36(4): 486-491.
5.	萇新偉, 馬秀現, 李健, 等. 膽囊肉瘤樣癌臨床分析 12 例. 世界華人消化雜志, 2016, 24(13): 2063-2069.
6.	譚元元, 武世伍, 柴大敏, 等. 肺肉瘤樣癌 10 例并臨床病理分析. 臨床與實驗病理學雜志, 2016, 32(11): 1287-1289.
7.	王延林, 劉良發, 李亞卓, 等. 11 例頭頸部肉瘤樣癌臨床分析. 中國耳鼻咽喉顱底外科雜志, 2013, 19(1): 9-14.
8.	陳鵬程, 陳奇勛, 倪型灝, 等. 食管肉瘤樣癌的臨床病理特征及預后分析. 中華腫瘤雜志, 2012, 34(4): 287-290.
9.	李春筍, 陳旭東, 何松, 等. 食管肉瘤樣癌的臨床病理特征及預后分析(附 20 例報告). 南京醫科大學學報: 自然科學版, 2013, 33(11): 1566-1568.
10.	Iyomasa S, Kato H, Tachimori Y, et al. Carcinosarcoma of the esophagus: a twenty-case study. Jpn J Clin Oncol, 1990, 20(1): 99-106.
11.	王洪云, 候慶寶, 曹慧. 食管肉瘤樣癌的臨床特征與病理對照研究. 中國實用醫藥, 2014(29): 30-31.
12.	Li CS, Xu JZ, Tian SH, et al. Clinical pathology analysis of esophageal sarcomatoid carcinomn. Chinese-German J Clin Oncol, 2014, 13(5): 235-239.
13.	周實, 馬樹華, 李曼紅. 食管癌肉瘤和肉瘤樣癌 X 線、病理分析. 臨床放射學雜志, 2009, 28(12): 1698-1699.
14.	余振, 程邦昌, 昌盛, 等. 食管癌肉瘤 22 例臨床病理分析. 中華胃腸外科雜志, 2008, 11(3): 235-237.
15.	方銑華, 陳波, 吳梅娟. 食管肉瘤樣癌. 河南腫瘤學雜志, 2002, 15(4): 237-239.
16.	趙爾增, 張建中, 鄭燕華, 等. 食管肉瘤樣癌臨床病理和免疫組化分析. 腫瘤防治雜志, 2004, 11(12): 1304-1306.
17.	Wang L, Lin Y, Long H, et al. Esophageal carcinosarcoma: a unique entity with better prognosis. Ann Surg Oncol, 2013, 20(3): 997-1004.
18.	Sano A, Sakurai S, Kato H, et al. Clinicopathological and immunohistochemical characteristics of esophageal carcinosarcoma. Anticancer Res, 2009, 29(8): 3375-3380.
19.	黃志軍, 邱建龍, 郭啟祥. 14 例食管肉瘤樣癌的臨床病理分析. 臨床腫瘤學雜志, 2006, 11(11): 844-845.
20.	Kashiwabara K, Sano T, Oyama T, et al. A case of esophageal sarcomatoid carcinoma with molecular evidence of a monoclonal origin. Pathol Res Pract, 2001, 197(1): 41-46.
21.	Ohtaka M, Kumasaka T, Nobukawa B, et al. Carcinosarcoma of the esophagus characterized by myoepithelial and ductal differentiations. Pathol Int, 2002, 52(10): 657-663.
22.	Lam KY, Law SY, Loke SL, et al. Double sarcomatoid carcinomas of the oesophagus. Pathol Res Pract, 1996, 192(6): 604-609.
23.	Nakagawa S, Yabusaki H, Tanaka O. Rapid-growth carcinosarcoma of the esophagus arising from 0-Ⅱc squamous cell carcinoma after definitive chemoradiotherapy: a case report. Esophagus, 2009, 6(2): 123-126.
24.	Ogasawara N, Tamura Y, Funaki Y, et al. Rapidly growing esophageal carcinosarcoma reduced by neoadjuvant radiotherapy alone. Case Rep Gastroenterol, 2014, 8(2): 227-234.
25.	Lauwers GY, Grant LD, Scott GV, et al. Spindle cell squamous carcinoma of the esophagus: analysis of ploidy and tumor proliferative activity in a series of 13 cases. Hum Pathol, 1998, 29(8): 863-868.
26.	許豐, 吳楊慶, 馬涵, 等. 食管肉瘤樣癌內鏡切除的臨床價值初步探討. 中華消化內鏡雜志, 2016, 33(5): 334-336.
27.	Zuiki T, Hosoya Y, Ui T, et al. Therapeutic effectiveness of chemoradiotherapy for carcinosarcoma of the esophagus: two case reports and a review of the literature. Esophagus, 2009, 6(3): 189-195.
28.	Kobayashi D, Koike M, Kodera Y, et al. Carcinosarcoma of the esophagus treated with chemoradiotherapy: report of four cases. Esophagus, 2010, 7(2): 119-125.
29.	Joseph RW, Millis SZ, Carballido EM, et al. PD-1 and PD-L1 expression in renal cell carcinoma with sarcomatoid differentiation. Cancer immunology research, 2015, 3(12): 1303-1307.
30.	Vieira T, Antoine M, Hamard C, et al. Sarcomatoid lung carcinomas show high levels of programmed death ligand-1 (PD-L1) and strong immune-cell infiltration by TCD3 cells and macrophages. Lung Cancer, 2016, 98: 51-58.
31.	Velcheti V, Rimm DL, Schalper KA. Sarcomatoid lung carcinomas show high levels of programmed death ligand-1 (PD-L1) J Thorac Oncol, 2013, 8(6): 803-805.
32.	Kim S, Kim MY, Koh J, et al. Programmed death-1 ligand 1 and 2 are highly expressed in pleomorphic carcinomas of the lung: comparison of sarcomatous and carcinomatous areas. Eur J Cancer, 2015, 51(17): 2698-2707.
33.	Pelosi G, Gasparini P, Conte D, et al. Synergistic activation upon Met and ALK coamplification sustains targeted therapy in sarcomatoid carcinoma, a deadly subtype of lung cancer. J Thorac Oncol, 2016, 11(5): 718-728.
34.	Zhang HL, Zhu Y, Qin XJ, et al. c-KIT: potential predictive factor for the efficacy of sorafenib in metastatic renal cell carcinoma with sarcomatoid feature. Clin Genitourin Cancer, 2013, 11(2): 134-140.
35.	Geynisman DM. Anti-programmed cell death protein 1 (PD-1) antibody nivolumab leads to a dramatic and rapid response in papillary renal cell carcinoma with sarcomatoid and rhabdoid features. Eur Urol, 2015, 68(5): 912-914.

1. 丁華野, 廖松林. 癌肉瘤和肉瘤樣癌. 診斷病理學雜志, 1999(1): 60-61.
2. 方銑華, 林雪平. 肉瘤樣癌及癌肉瘤的新認識. 腫瘤研究與臨床, 2005, 17(2): 138-139.
3. Raza MA, Mazzara PF. Sarcomatoid carcinoma of esophagus. Arch Pathol Lab Med, 2011, 135(7): 945-948.
4. 焦亮, 王涌泉. 腎肉瘤樣癌研究進展. 臨床與病理雜志, 2016, 36(4): 486-491.
5. 萇新偉, 馬秀現, 李健, 等. 膽囊肉瘤樣癌臨床分析 12 例. 世界華人消化雜志, 2016, 24(13): 2063-2069.
6. 譚元元, 武世伍, 柴大敏, 等. 肺肉瘤樣癌 10 例并臨床病理分析. 臨床與實驗病理學雜志, 2016, 32(11): 1287-1289.
7. 王延林, 劉良發, 李亞卓, 等. 11 例頭頸部肉瘤樣癌臨床分析. 中國耳鼻咽喉顱底外科雜志, 2013, 19(1): 9-14.
8. 陳鵬程, 陳奇勛, 倪型灝, 等. 食管肉瘤樣癌的臨床病理特征及預后分析. 中華腫瘤雜志, 2012, 34(4): 287-290.
9. 李春筍, 陳旭東, 何松, 等. 食管肉瘤樣癌的臨床病理特征及預后分析(附 20 例報告). 南京醫科大學學報: 自然科學版, 2013, 33(11): 1566-1568.
10. Iyomasa S, Kato H, Tachimori Y, et al. Carcinosarcoma of the esophagus: a twenty-case study. Jpn J Clin Oncol, 1990, 20(1): 99-106.
11. 王洪云, 候慶寶, 曹慧. 食管肉瘤樣癌的臨床特征與病理對照研究. 中國實用醫藥, 2014(29): 30-31.
12. Li CS, Xu JZ, Tian SH, et al. Clinical pathology analysis of esophageal sarcomatoid carcinomn. Chinese-German J Clin Oncol, 2014, 13(5): 235-239.
13. 周實, 馬樹華, 李曼紅. 食管癌肉瘤和肉瘤樣癌 X 線、病理分析. 臨床放射學雜志, 2009, 28(12): 1698-1699.
14. 余振, 程邦昌, 昌盛, 等. 食管癌肉瘤 22 例臨床病理分析. 中華胃腸外科雜志, 2008, 11(3): 235-237.
15. 方銑華, 陳波, 吳梅娟. 食管肉瘤樣癌. 河南腫瘤學雜志, 2002, 15(4): 237-239.
16. 趙爾增, 張建中, 鄭燕華, 等. 食管肉瘤樣癌臨床病理和免疫組化分析. 腫瘤防治雜志, 2004, 11(12): 1304-1306.
17. Wang L, Lin Y, Long H, et al. Esophageal carcinosarcoma: a unique entity with better prognosis. Ann Surg Oncol, 2013, 20(3): 997-1004.
18. Sano A, Sakurai S, Kato H, et al. Clinicopathological and immunohistochemical characteristics of esophageal carcinosarcoma. Anticancer Res, 2009, 29(8): 3375-3380.
19. 黃志軍, 邱建龍, 郭啟祥. 14 例食管肉瘤樣癌的臨床病理分析. 臨床腫瘤學雜志, 2006, 11(11): 844-845.
20. Kashiwabara K, Sano T, Oyama T, et al. A case of esophageal sarcomatoid carcinoma with molecular evidence of a monoclonal origin. Pathol Res Pract, 2001, 197(1): 41-46.
21. Ohtaka M, Kumasaka T, Nobukawa B, et al. Carcinosarcoma of the esophagus characterized by myoepithelial and ductal differentiations. Pathol Int, 2002, 52(10): 657-663.
22. Lam KY, Law SY, Loke SL, et al. Double sarcomatoid carcinomas of the oesophagus. Pathol Res Pract, 1996, 192(6): 604-609.
23. Nakagawa S, Yabusaki H, Tanaka O. Rapid-growth carcinosarcoma of the esophagus arising from 0-Ⅱc squamous cell carcinoma after definitive chemoradiotherapy: a case report. Esophagus, 2009, 6(2): 123-126.
24. Ogasawara N, Tamura Y, Funaki Y, et al. Rapidly growing esophageal carcinosarcoma reduced by neoadjuvant radiotherapy alone. Case Rep Gastroenterol, 2014, 8(2): 227-234.
25. Lauwers GY, Grant LD, Scott GV, et al. Spindle cell squamous carcinoma of the esophagus: analysis of ploidy and tumor proliferative activity in a series of 13 cases. Hum Pathol, 1998, 29(8): 863-868.
26. 許豐, 吳楊慶, 馬涵, 等. 食管肉瘤樣癌內鏡切除的臨床價值初步探討. 中華消化內鏡雜志, 2016, 33(5): 334-336.
27. Zuiki T, Hosoya Y, Ui T, et al. Therapeutic effectiveness of chemoradiotherapy for carcinosarcoma of the esophagus: two case reports and a review of the literature. Esophagus, 2009, 6(3): 189-195.
28. Kobayashi D, Koike M, Kodera Y, et al. Carcinosarcoma of the esophagus treated with chemoradiotherapy: report of four cases. Esophagus, 2010, 7(2): 119-125.
29. Joseph RW, Millis SZ, Carballido EM, et al. PD-1 and PD-L1 expression in renal cell carcinoma with sarcomatoid differentiation. Cancer immunology research, 2015, 3(12): 1303-1307.
30. Vieira T, Antoine M, Hamard C, et al. Sarcomatoid lung carcinomas show high levels of programmed death ligand-1 (PD-L1) and strong immune-cell infiltration by TCD3 cells and macrophages. Lung Cancer, 2016, 98: 51-58.
31. Velcheti V, Rimm DL, Schalper KA. Sarcomatoid lung carcinomas show high levels of programmed death ligand-1 (PD-L1) J Thorac Oncol, 2013, 8(6): 803-805.
32. Kim S, Kim MY, Koh J, et al. Programmed death-1 ligand 1 and 2 are highly expressed in pleomorphic carcinomas of the lung: comparison of sarcomatous and carcinomatous areas. Eur J Cancer, 2015, 51(17): 2698-2707.
33. Pelosi G, Gasparini P, Conte D, et al. Synergistic activation upon Met and ALK coamplification sustains targeted therapy in sarcomatoid carcinoma, a deadly subtype of lung cancer. J Thorac Oncol, 2016, 11(5): 718-728.
34. Zhang HL, Zhu Y, Qin XJ, et al. c-KIT: potential predictive factor for the efficacy of sorafenib in metastatic renal cell carcinoma with sarcomatoid feature. Clin Genitourin Cancer, 2013, 11(2): 134-140.
35. Geynisman DM. Anti-programmed cell death protein 1 (PD-1) antibody nivolumab leads to a dramatic and rapid response in papillary renal cell carcinoma with sarcomatoid and rhabdoid features. Eur Urol, 2015, 68(5): 912-914.

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