ESD:早期胃癌的新选择

Endoscopic Submucosal Dissection:a new option for early gastric cancer

早期胃癌(EGC)侵及部位限于黏膜及黏膜下层,淋巴结转移率较低,手术治疗5年生存率超过90%。内镜黏膜下剥离术(ESD)作为EGC内镜治疗方法,可以获得与传统手术相似的治愈率,相对组织损伤小,胃部功能影响小、患者负担轻、对生活质量影响少,现正逐渐成为EGC首选的治疗方案,但其临床应用存在治疗指征被放宽的现象,对于术后患者随访及高危患者管理尚缺乏统一的规范。ESD作为新兴技术在EGC中应用前景广阔。本文就内镜在EGC的治疗方面的临床应用最新进展做一介绍。

Early gastric cancer （EGC） mostly invades and locates at the mucosa and submucosal layer, and it has a low rate in lymph node metastasis. The 5-year-survival rate of operation therapy is above 90%. Endoscopic submucosal dissection （ESD）, as a type of endoscopic treatment of EGG, can acquire similar recovery rate as traditional surgery, but it involves relative small tissue damage, low influence to patient＇s stomach function, quality of life and mental burden. Nowadays, there is an increasing trend in placing ESD as the preferred treatment of EGC. However, ESErs indications are loosened in the application. In addition, there is still a lack of comprehensive and unified management system for postoperative and high risk patients. Endoscopic submucosat dissection, a new technology in early gastric cancer treatment, has a broad prospect in future applications. In this article, we introduce the latest progress in the clinical application of endoscopy in treating EGC.