放射性食管炎的临床研究现状

Current Clinical Status of Radioactive Esophagitis

放射性食管炎是临床上对肺癌,乳腺癌和食管癌等常见癌症晚期治疗过程中或治疗后出现的一种非特异性炎症。放射性食管炎起病急,一般在放射治疗后的2个月内发病。其典型的临床表现与内镜下病变通常无特异性,因此不能作为诊断的相关依据。病变组织活检可以发现炎性改变的多变性和辐射相关的内皮细胞与间质细胞的异型性。这种异型性病变与巨细胞病毒导致的细胞病变相类似,但两者能通过免疫染色进行鉴别。放射性食管炎的治疗主要以支持对症为主,最近干细胞治疗成为其研究热点。其预后多为自限性,但有时也会出现癌症和食管狭窄等。放射性食管炎是局部放射治疗后的一种继发症,随着临床放疗的进展,放射性食管炎也得到了人们的关注,现本文对放射性食管炎的研究现状作一综述进行总结。

Radioactive esophagitis is the nonspecific inflammation during or after the treatment of many common terminal can- cer, such as lungbreast and esophagus. Radioactive esophagitis occurs acutely, generally within 2 months after radiotherapy. Its typical presentations as well as endoscopic changes are nonspecific and nondiaguostic. Biopsy from impaired tissue display the inflammatory changes of variability and associated with radiation atypia of endothelial and stromal cells. The lesions with cytomegalovirus cytopathic changes is similar, which can be excluded by absence of immunostaining. Radioactive esophagitis is mainly treated symptomatically, re- cently stem cell therapy became research hotspot. Radiation esophagitis is usually self-limited, however, cancer and esophageal stricture can also appear. Radioactive esophagitis is one of clinical unexpected complications in patients undergoing partial radiotherapy. Radioac- tive esophagitis got extensive concern as the progress of radiotherapy. This review summarized the research status of radioactive esophagitis.