早期和浅表性食管鳞状细胞癌内镜治疗现状

Endoscopic treatment for early and superficial esophageal squamous cell carcinoma

食管癌目前已成为我国主要恶性肿瘤之一,其发病率和病死率逐年增加,发病原因多而复杂。早期食管鳞状细胞癌是指局限于食管黏膜层的鳞状细胞癌,而侵犯到黏膜下层的鳞状细胞癌属于浅表性食管癌。随着内镜检查的普及和技术的进步,早期和浅表性食管鳞状细胞癌的诊断率不断提高,目前内镜下治疗的方法主要有内镜下切除和非切除治疗,其中内镜下切除治疗主要有内镜下黏膜切除术、内镜下黏膜剥离术等,相对于手术治疗,内镜下切除治疗具有安全、创伤小、操作简单、并发症少等优点,提高了患者的生存质量。但对于淋巴结转移风险较大的患者,若行内镜下治疗后,建议术后密切随访。随着针对较大病变的内镜下隧道式黏膜下剥离术等技术的开展,内镜下治疗将会为早期食管肿瘤的患者提供更好的治疗方案。

Esophageal cancer has become one of the main malignant tumors in China with its increasing morbidity and mortality. The causes of esophageal cancer are numerous and complicated. Early esophageal squamous cell carcinoma refers to lesions which confined to the esophageal mucosa and when the lesions invade the esophageal submucosa is called superficial esophageal squamous cell carcinoma. With the popularity of endoscopy and the advancement of technology, the diagnosis rate of early and superficial esophageal squamous cell carcinoma are improving. At present, endoscopic treatment mainly includes endoscopic resection and endoscopic non-resection. Among them, endoscopic resection includes EMR, ESD, etc. Compared with surgical treatment, endoscopic resection has the advantages of safety, less trauma, simple operation and fewer complications, consequently, patient′s quality of life is improved. However, for patients with a high risk of lymph node metastasis, it is recommended to follow up closely after endoscopic treatment. With the development of methods such as ESTD for larger lesions, endoscopic treatment will provide a better treatment for patients with early esophageal tumors.