[A clinico-pathological study of the intraepithelial spreading of esophageal carcinomas]

One hundred and twenty-nine esophageal epidermoid carcinomas have been found to have 60 intraepithelial-spreading lesions. According to the histological of these intraepithelial-spreading lesions, 60 of these lesions could be divided to two types: a whole type and a basal type. Thirty-three lesions (55%) were found to be a whole type and twenty-three lesions (38%) a basal type, and the remaining four lesions (7%) a mixed type. Sixty-seven percent of the whole type lesions were accompanied by well differentiated epidermoid carcinomas, and 33% with poorly or moderately differentiated epidermoid carcinomas. On the other hand, 17% of the basal type lesions were accompanied by well differentiated epidermoid carcinomas, and 83% with a poorly or moderately differentiated epidermoid carcinomas. The average length of spreading of the whole type was 14.5 mm, and the average length of spreading of the basal type, 19.6 mm. It was found that the intraepithelial spreading of the poorly differentiated epidermoid carcinomas (average: 23.6 mm) was longer than the well differentiated epidermoid carcinomas (average: 15.8 mm). A histological examination of step sections revealed that 34% of the intra-spreading lesions had erosions. Further half of the lesions over 10 mm in length also had erosions. Basal type carcinomas had a greater frequency of erosion than did the whole type carcinomas. Papillary growth pattern was a special histological feature of the whole type, and a pagetoid spreading was distinctive in the basal type. The macroscopical appearance of the mucosal surface of the whole type was granular or nodular, whereas for the basal type it was redness or no change.