32例食管和贲门早期浅表癌内镜激光治疗远期疗效

LONG-TERM EFFICACY OF ENDOSCOPIC LASER THERAPY IN 32 PATIENTS WITH EARLY SUPERFICIAL CARCINOMA OF THE ESOPHAGUS AND THE GASTRIC CARDIA

对内镜Ｎｄ：ＹＡＧ激光治疗细胞消失的３２例食管和贲门早期浅表癌病人进行了３３～７８个月（平均５５．２５个月）的前瞻性随访。应用ＰｒｏｄｕｃｔＬｉｍｉｔＥｓｔｉｍａｔｅ方法计算其存活率，并与１１７例早期食管癌和贲门癌的自然病程对比分析。内镜激光治疗五年存活率为９７％，未经治疗的早期食管贲门癌的五年存活率为６７％（Ｐ＜０．０１），表明内镜激光是一种有效的治疗方法。在对影响疗效的因素中，发现抗癌基因Ｐ５３是一个非常有价值的独立预后因素。

patients with early superficial carcinoma of the esophagus and the gastric cardia were treated by endoscopic Nd:YAG laser therapy. Of the 33 patients, 32(97%) cases were cured, resulting in the disappearance of the cancer cells. They were followd up for 33-78months, with a mean of 55. 25 months. The survivorship function of the 32 patients treated by endoscopic laser was computed with the Product Limit estimate method, and was compared with the natural history of early superficial carcinoma of the esophagus and the gastric cardia. The five-year survival rate was in 97% of the 32 patients treated with laser therapy.in contrast to 67% (P<0. 01) of 117 untreated patients with early superficial cancer. It might be concluded that endoscopic Nd: YAG laser is a safe and effetive therapy for early carcinoma of the esophagus and the gastric cardia. Moreover,it is suggested that P53 protein may be a Valuable parameter for predicting the prognosis.