食管癌的病理分型有哪些 刘陶东 山西省肿瘤医院

食管癌的病理分型有哪些 刘陶东 山西省肿瘤医院
病理形态分型有以下几种：一、早期食管癌的病理形态分型，早期食管癌按其形态可分为隐伏型、糜烂型、斑块型和乳头型，其中以斑块型为最多见，占食管早期癌的二分之一左右，此型癌细胞分化较好，糜烂型占三分之一左右，癌细胞的分化较差，隐伏型病变最早，均为原发癌，但仅占早期食管癌的十分之一左右，乳头型病变较晚，随癌细胞分化一般较好，但手术所见属原位癌者较少见。二、中晚期食管癌的病理形态分型，可分为髓质型、蕈伞型、溃疡型、缩窄型、腔内型和未分化型，其中，髓质型恶性程度最高，并占中晚期食管癌的二分之一以上，此型癌肿可侵犯食管壁的各层，并向腔内外扩展，食管周径的全部或大部以及食管周围结缔组织均可受累，癌细胞分化程度不一，蕈伞型约占中晚期食管癌的六分之一到五分之一，癌瘤多呈圆形或卵圆形肿块，向食管腔内形蕈伞状突起，可累及食管壁的大部，溃疡型及缩窄型各占食管中晚期食管癌的十分之一左右，溃疡型表面多有较深的溃疡、出血及转移较早，而发生梗阻交晚，缩窄型呈环形生长且多累及食管全周，食管粘膜呈向心性收缩，故出现梗阻较早而出血和转移发生较晚。

What are the pathological types of esophageal cancer
There are several types of pathological types: 1. Pathological types of early esophageal cancer, Early esophageal cancer can be divided into concealed type, erosive type, plaque type and papillary type, Plaque type is the most common, It accounts for about half of early esophageal cancer, This type of cancer cells differentiated well, Erosion type accounts for about one third, The differentiation of cancer cells is poor, Concealed lesions are the earliest, All of them were primary cancer, But it only accounts for about one tenth of early esophageal cancer, Papillary lesions are late, Generally, it is better to differentiate with cancer cells, However, it is rare to see carcinoma in situ. 2、 Pathological types of esophageal carcinoma in the middle and late stage, It can be divided into medullary type, mushroom type, ulcer type, constriction type, endoluminal type and undifferentiated type, Among them, The malignant degree of medullary type is the highest, It accounts for more than half of the advanced esophageal cancer, This type of cancer can invade all layers of esophageal wall, And expand to the inside and outside of the cavity, All or most of the periesophageal diameter and the connective tissue around the esophagus can be affected, The differentiation degree of cancer cells is different, Toadstool type accounts for about one sixth to one fifth of advanced esophageal cancer, Most tumors are round or oval masses, The toadstool like process is formed in the lumen of the esophagus, Most of the esophageal wall can be involved, Ulcerative type and constrictive type account for about one tenth of esophageal cancer in the middle and late stage, The surface of ulcer type usually has deep ulcer, bleeding and metastasis earlier, But the obstruction happened later, The constricted type is ring-shaped and mostly involves the whole esophagus, The esophageal mucosa contracted centripetally, Therefore, obstruction occurs earlier and bleeding and metastasis occur later.