色素染色后微波凝固法在食管癌前病变中应用的再认识

Review of Microwave Coagulation Therapy after Dye Staining in Esophageal Precancerous Lesions

目的探讨色素染色后再行微波凝固法治疗食管癌前病变的应用价值,以期得到最佳治疗效果。方法回顾性分析我院2000年前胃镜下病理证实为食管癌前病变行微波凝固法治疗119例(对照组)与2000年以来采用色素染色后行微波电烙样凝固治疗189例(研究组)的临床资料。结果两组治疗后3个月、6个月时消退率、复发率和癌变率比较无明显差异(P>0.05);1年和2年时的复发率比较,研究组低于对照组,差异有统计学意义(P<0.05);3年、4年和5年时消退率、复发率和癌变率比较,研究组优于对照组,差异均有统计学意义(P<0.05)。结论充分认识微波凝固法治疗前的染色定位,是食管癌前病变提高消退率、降低复发率和癌变率的关键因素。

Objective To evaluate the effect of microwave coagulation therapy after dye staining used in esophageal precancerous lesions. Methods A retrospective analysis was made in 119 patients of esophageal precancerous lesions confirmed pathologically and treated by microwave coagulation before 2000 （the control group）, and in 189 patients under- taking microwave coagulation treatment after chromoendoscopy since 2000 （the study group）. Results There was no sig- nificant difference between the two groups in regression rate, recurrence rate and canceration rate after three months and six months （P 〉 0. 05）. Recurrence rate of the study group was lower than that of the control group in the first year and the second year （P 〈0.05）. There was significant difference between the two groups in regression rate, recurrence rate and canceration rate in the third, the fourth and the fifth year （ P 〈 0. 05 ）. Conclusion Staining before microwave coagulation therapy for pre-positioning of the lesions is a key factor to improve the regression rate and reduce the recurrence rate and canceration rate.