食管切除术治疗食管上皮重度不典型增生的临床价值分析

The clinical value of esophagectomy for esophageal epithelial cells with severe dysplasia

目的：分析食管切除术对食管上皮细胞重度不典型增生（SDP）的临床价值。方法回顾性分析2000年1月至2012年1月解放军总医院收治的33例经内镜活检确诊为 SDP 且行手术切除患者的术后病理结果、复发率、淋巴结转移率、5年生存率。结果33例患者经外科手术切除术后，病理证实原位癌9例（27.3%），浸润癌18例（54.5%），其中3例 Barrett 食管癌变（9.1%），3例 SDP（9.1%）；总体复发率及区域淋巴结转移率为零；5年生存率为100%；围手术期手术并发症少，随访6～62月，患者复查均无瘤生存。结论食管切除术治疗食管上皮重度不典型增生术后无复发及转移，生存周期长，治疗效果好，在治疗 SDP 患者中具有重要临床价值。

Objective Toanalyze the clinical value of esophagectomy for esophagealepithelialcells with severe dysplasia(SDP). Methods Retrospectively analyzed 33 cases'' postoperative pathology outcomes, recurrence rate, lymph node metastasis rate, 5 years'' survival rate, all patients were diagnosed as SDP by preoperative endoscopy. Results For 33 cases undergone esophagectomy, 9 cases were carcinoma in situ(27.3%), 18 cases were infiltrating carcinoma(54.5%), 3 cases were Barrett''s esophageal carcinogenesis(9.1%), 3 cases were SDP(9.1%), total recurrence rate and regional lymph node metastasis rate were 0%, 5 years'' survival rate was 100%, no complication in peroperative period. Follow-up period from 6 months to 62 months after surgery. Conclusion There were no recurrence and lymph node metastasis for esophagectomy to treat with esophageal epithelial cells with severe dysplasia, had high survival rate and better curative effect, had important clinical value for treating SDP patients.