食管癌环周切缘阳性对预测食管癌预后的研究现状

Current status of prognostic evaluation of esophageal cancer patients by circumferential resection margin

食管癌因其恶性程度高、预后差,已经成为全球恶性肿瘤相关死亡的第6位主要原因。近几十年来,尽管食管癌的诊断和治疗取得了长足进步,新技术和新器械的使用以及新辅助治疗的应用显著改善了食管癌的治疗状况,但食管癌患者的5年生存率仍停留在较低水平。常见临床病理因素如原发肿瘤、区域淋巴结和远处转移以及食管癌病灶的纵向切缘情况、淋巴管侵犯和周围神经侵犯均被证实为食管癌预后的重要预测因子。环周切缘对于食管癌预后的预测价值仍然存在争议,食管癌环周切缘阳性的准确定义也具有争议。

Esophageal cancer is the sixth leading cause of cancer-related death worldwide due to its high malignancy and poor prognosis. In recent decades, the applications of new technologies, devices and neoadjuvant therapy lead to the great progress in the diagnosis and treatment of esophageal cancer. However, the five-year survival rate of esophageal cancer remains unsatisfied. Clinical and pathological factors such as the primary tumor (T), regional lymph nodes (N) and distant metastasis (M) and the longitudinal margins of esophageal lesions, lymphatic invasion, peripheral nerve invasion have been identified as important predictors of the prognosis of esophageal cancer. However, the effect of circumferential resection margin on the prognosis evaluation of esophageal cancer is still controversial, and no definite identification of circumferential resection margin of esophageal cancer has been acknowledged worldwide. Therefore, the studies of circumferential resection margin involvement in predicting the prognosis of esophageal cancer are reviewed.