摘要
目的观察内镜下黏膜切除术(EMR)治疗早期食管癌和癌前病变的长期生存率。方法随访前期154例经EMR治疗的早期食管癌和癌前病变的患者,分别于术后1个月、6个月和12个月进行内镜复查,如发现有可疑局部复发,则立即进行氩离子凝固术(APC)治疗。术后1年后,每年随访1次,随诊率100%。结果术后5年内发现病变复发6例,复发率为3.9%(6/154),其中4例接受食管切除手术治疗,1例采用APC治疗,另1例因复发癌转移死亡。本组共发生4例死亡,包括1例因复发癌转移死亡和3例非癌死亡,5年生存率为97.4%(150/154)。其中重度异型增生、原位癌和黏膜内癌共125例,发生2例非癌死亡和1例复发癌转移死亡,5年生存率为97.6%(122/125);中度异型增生29例,发生1例非癌死亡,5年生存率为96.6%(28/29)。结论EMR适合于早期食管癌和癌前病变的治疗,特别是重度异型增生、原位癌和黏膜内癌,其创伤小、痛苦少,几乎无后遗症,有很好的长期生存效果。
Objective To evaluate the long-term survival rate of precancerous lesions and early esophageal cancer after endoscopic mueosal resection (EMR). Methods The follow-up endoscopy was performed in 154 patients with early esophageal cancer and precancerous lesions who underwent EMR. The examinations were carried out at 1 month, 6 months and every 1 year after the procedure, respectively, and argon plasma coagulation (APC) was applied if a recurrent lesion was suspected. The follow-up rate was 100%. Results After EMR, reccurencc occurred in 6 cases (3.9%) in 5 years, of which 4 received esophagectmy, 1 underwent APC, and the other one died from matastasis. The 5-year survival rate was 97.4% (150/154) , with 1 died from malastasis and 3 from noncancerous diseases. The 5-year survival rate of 125 patients with high grade dysplasia, carcinoma in situ and intramueosal carcinoma was 97.6% ( 122/ 125), with 1 died from noncancerous disease and 1 from metastasis. The 5-year survival rate of 29 patients with low grade dysplasia was 96.6% (28/29) with 1 patient died from noncancerous disease. Conclusion EMR, as a minimally invasive procedure, is suitable for precancerous lesions and early esophageal cancer, especially for high grade dysplasia, carcinoma in situ and intramucosal carcinoma, with little sequela and long-term survival.
出处
《中华消化内镜杂志》
2008年第11期584-586,共3页
Chinese Journal of Digestive Endoscopy
关键词
食管肿瘤
癌前状态
内镜下黏膜切除术
Esophageal neoplasms
Precancerous conditious
Endoscopic mucosal resection