超声内镜指导下行内镜黏膜剥离术治疗食管癌前病变的效果分析

Effect of Endoscopic Mucosal Dissection under Endoscopic Ultrasonography in Treatment of Esophageal Precancerous Lesions

目的:探讨食管癌前病变采用超声内镜指导下行内镜下黏膜剥离术(ESD)治疗的效果。方法:选择2017年5月-2019年5月在笔者所在医院接受治疗的食管癌前病变患者80例,依据盲抽法分为两组,各40例。对照组实施常规ESD,观察组在超声内镜指导下行ESD,比较两组应激反应[肾素(R)、去甲肾上腺素(NE)、肾上腺素(E)]、肿瘤标志物[重组人Dickkopf相关蛋白1(DDK-1)、麟上皮细胞癌抗原(SCC-Ag)、细胞角质蛋白19片段抗原21-1(Cyfra21-1)]、并发症、创面愈合及复发情况。结果:术后即刻,观察组R、NE、E水平及DDK-1、SCC-Ag、Cyfra21-1含量均低于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率及复发率均低于对照组,创面愈合率高于对照组,差异均有统计学意义(P<0.05)。结论:食管癌前病变采用超声内镜指导下行ESD治疗的安全性及有效性高,可有效降低肿瘤标志物水平,减轻局部损伤,减少复发。

Objective:To investigate the efficacy of endoscopic stripping (ESD) in treatment of esophageal precancerous lesions.Method:From May 2017 to May 2019,80 patients with precancerous lesions of esophageal cancer treated in our hospital were selected,and were divided into two groups according to blind sampling,with 40 cases in each group.The control group was treated with conventional ESD,the observation group was treated with ESD under the guidance of endoscopic ultrasonography.The stress responses [renin (R),norepinephrine (NE),epinephrine (E)],tumor markers [recombinant human Dickkopf related protein 1(DDK-1),lin epithelial cell carcinoma antigen (SCC-Ag),cyt keratin 19 fragment antigen 21-1 (Cyfra21-1)],complications,wound healing and recurrence were compared between the two groups.Result:Immediately after operation,the R,NE,E level and DDK-1,SCC-Ag,Cyfra21-1 content in the observation group were lower than those in the control group immediately after operation (P<0.05).The incidence of complications and recurrence rate in the observation group were lower than those in the control group,and the wound healing rate was higher than that in the control group,the differences were statistically significant (P<0.05).Conclusion:The treatment of esophageal precancerous lesions with ESD guided by endoscopic ultrasonography is safe and effective,can effectively reduce the level of tumor markers,reduce local injury,reduce recurrence.