[Characteristics of the spread pattern in esophageal carcinoma]

The correlation of spread pattern with various clinical and histopathological factors was studied using macroscopic and microscopic findings of 284 patients who had undergone resection for esophageal carcinoma without pre-operative treatment. Macroscopic evaluation were made according to new classification proposed by the Japanese Pathological Research Committee for esophageal carcinoma. The location of primary tumour, length, macroscopic type, the depth of penetration, and extranodal lymphatic and vessel permination of cancer cells (Exn-LV-Pm) had a correlation with the lymph node metastasis and the prognosis. The protruded type, ulcerative and localized type of tumor had a comparatively low lymph nodes metastases. On the other hand, ulcerative and infiltrative type, diffusely type of tumor had high incidence of lymph node metastasis. Histopathological findings for small size and non-penetrating of tumor shows variant histological type: e.g. undifferentiated carcinoma (3), adeno-squamous (3), P/D squamous cell carcinoma (8), M/D sq. cell ca. (12), W/D sq. cell ca. (4). The penetrating small tumour was almost M/D and W/D squamous cell carcinoma. For the purpose to clarify the pattern of lymph stream for esophageal carcinoma, we examined the status of lymph node metastasis of comparatively early carcinoma (sm. or mp.) relating to the site of primary tumor. Tumor in the middle esophagus drained into the mediastinal lymph nodes. Tumor in lower esophagus drained only into the abdominal lymph nodes. Microscopic examination of extranodal lymphatic and vessel permeation (Exn-LV-Pm) for dissected lymph nodes was carried out 71 cases. The positive cases of Exn-LV-Pm was 33%.(ABSTRACT TRUNCATED AT 250 WORDS)