超声内镜在食管癌分期及治疗评价中的应用

The application of endoscopic ultrasonography in staging and treatment of esophageal cancer

食管癌是我国最为常见的恶性肿瘤之一,其发病率及病死率均较高,严重威胁着人类的健康与生命。手术治疗仍是早期食管癌的首选治疗方法,但我国大多数患者在初诊时已处于中晚期,往往失去了根治性手术的机会;化疗作为一种全身性治疗手段,可应用于中晚期食管癌患者,但由于其作用有限、不能明显缓解患者进食梗阻症状,且化疗毒副作用较大,部分患者不能耐受;因此,放射治疗俨然成为食管癌治疗中不可或缺的重要措施之一。如何对食管癌TNM分期及治疗效果做出客观、科学的评价,是有关学者长期以来的研究热点之一。超声内镜检查不仅可以直观地显示食管黏膜病变,管腔有无狭窄及穿孔,还可以检测出癌灶浸润深度、层次及周围淋巴结转移情况,在判断食管癌的分期及治疗前后的疗效评比中具有独特的优势。

Esophageal cancer is one of the most common malignant tumors in China.Its morbidity and mortality are high,which threaten human health and life.Surgery is still the first choice for early treatment of esophageal cancer,however,most of our patients in the first diagnosed at the advanced stage,often lose the chance of radical surgery.Chemotherapy as a systemic treatment,can be used in advanced esophageal cancer patients.Chemotherapy with limited role cannot significantly ease the symptoms of patients with eating obstruction,which with great side effects that some patients cannot tolerate.Therefore,radiation therapy has become an indispensable and important treatment of esophageal cancer.How to evaluate the TNM staging and treatment effect of esophageal cancer is one of the hotspots of the researcher.Endoscopic ultrasonography can not only show esophageal mucosal lesions,stenosis and perforation of the esophageal mucosa,but also can detect the infiltration depth,level and lymph node metastasis of esophageal carcinoma.EUS has a unique advantage in judging the staging of esophageal carcinoma and evaluating the curative effect before and after treatment.