위에 발생한 편평상피선암
Gastric Adenosquamous Carcinoma
대한암학회지 1999년 31권 4호 p.710 ~ 715
정재호, 신동운, 노성훈, 민진식,
소속 상세정보
정재호 ( )
연세대학교 의과대학 외과학교실
신동운 ( )
연세대학교 의과대학 외과학교실
노성훈 ( )
연세대학교 의과대학 외과학교실
민진식 ( )
연세대학교 의과대학 외과학교실
KMID : 0360319990310040710
Abstract
서론
위암은 우리 나라에서 가장 흔한 악성종양이며 또한 중요한 사망원인이다. 위에 발생하는
악성종양의 대부분은 조직학적으로 선암이며 편평상피선암은 전체 위암의 약 0.5%를 차지
하는 매우 드문 질환이다. 위에 발생하는 편평상피선암은 1905년 Rolleston과 Trevor가 처
음 보고하였으며 동양에서는 1937년 일본의 Takashiro에 의해 처음 보고된 바 있다. 국내에
서도 위편평상피선암에 대한 병리조직학적 특성 및 임상양상에 대한 연구는 드문 실정이다.
저자들은 병리조직학적으로 확인된 위편평상피선암 9예의 임상적 고찰을 통해 이 질환의 병
태생리 및 임상적 특성에 대해 알아보고자 한다.
Purpose : Adenosquamous carcinoma, a rare malignant tumor of the stomach, is
characterized by two different cell components, one adenomatous and the other
squamous component. Its clinicopathologic feature and prognosis are quite different from
the ordinary adenocarcinomas. We report our experience of 9 such cases.
Materials and Methods : Clinical and pathologic features were reviewed for the 9
patients who underwent gastrectomies and were confirmed as adenosquamous carcinoma
by pathologists during the 10-year period of from 1987 to 1998. Postoperative adjuvant
therapy and prognosis were also reviewed.
Results : The ages of 6 male and 3 female patients ranged from 30 to 59, with the
median age of 48. Total gastrectomy was done in 4 cases, while other underwent
subtotal gastrectomy. Curative resection was done in four cases. Fourteen additional
organs were rejected concomitantly due to suspicious tumor invasion and among them 9
organs were histologically confirmed for tumor invasion. The mean tumor size was 7.4
㎝ (2.5∼27 ㎝) and all cases were pathologically advanced. One case showed peritoneal
seeding and 3 cases showed hepatic metastases. There were 7 cases of stage Ⅳ disease
by the UICC TNM classification (5th ed.) and the other two were stage Ⅱ and stage
Ⅲb respectively. Eight cases received postoperative adjuvant chemotherapy comprising
5-FU, DDP, adriamycin, picibanil or VP-16. Of 9 patients, 6 died and the overall 5-year
survival rate was 15.3%.
Conclusion : Adenosquamous cancer of stomach is regarded as a disease of
unfavorable prognosis, which was confirmed by this study. The treatments were not
quite different from those for other stomach cancers. Although more cases and further
investigations are essential for complete understanding of the clinical prognosis and
proper treatment of the gastric adenosquarnous cancer, early diagnosis, curative resection
and close postoperative follow-ups are currently available options for better outcome of
this disease.
키워드
Adenosquamous carcinoma; Stomach;
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