消化内镜下黏膜剥离术治疗早期结直肠癌的效果

Digestive endoscopic mucosal dissection for the treatment of early colorectal cancer:clinical treatment analysis and its effects on patients′serum PGC-1αand SAA levels

目的:探究消化内镜下黏膜剥离术(ESD)治疗早期结直肠癌(CRC)的效果。方法:选取早期CRC患者125例,其中63例行ESD,62例行消化内镜下黏膜切除术(EMR)。比较两组手术时间,病灶整块切除率、完全切除率,术前术后血清PGC-1α、SAA水平,术后并发症发生率、肿瘤复发率和残留率。结果:ESD组手术时间长于EMR组(P<0.05);ESD病灶整块切除率、完全切除率高于EMR,两组病灶直径≥2 cm肿瘤患者病灶整块切除率、完全切除率均低于<2 cm者(P<0.05);术后两组血清PGC-1α、SAA水平降低,ESD降低幅度大于EMR(P<0.05);ESD术后并发症发生率高于EMR,肿瘤复发率和残留率低于EMR(P<0.05)。结论:ESD可有效治疗早期CRC,能够显著降低患者血清PGC-1α、SAA水平,且肿瘤复发率、残留率低,但手术时间长、术后并发症较多。

Aim:To explore the clinical efficacy of digestive endoscopic mucosal dissection(ESD)in the treatment of early colorectal cancer(CRC)and the changes of patients′serum peroxisome proliferator-activated receptorγcoactivator 1α(PGC-1α)and serum amyloid A(SAA)levels.Methods:A total of 125 patients with early CRC were selected,among whom 63 underwent ESD,and 62 underwent endoscopic mucosal resection(EMR).The operation time,en bloc resection rate,complete resection rate,serum PGC-1αand SAA levels before and after surgery,postoperative complication rate,tumor recurrence rate and residual rate were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group(P<0.05);the rates of en bloc resection and complete resection of the observation group were higher than those of the control group,and the en bloc resection rate and complete resection rate of tumor patients with lesions≥2 cm in both groups were lower than those of with lesions<2 cm(P<0.05);after the operation,the serum PGC-1αand SAA levels in the two groups were reduced,and the reduction in the observation group was greater than that in the control group(P<0.05);the incidence of postoperative complications in the observation group was higher than that in the control group,and the tumor recurrence rate and residual rate were lower than those in the control group(P<0.05).Conclusion:ESD can effectively treat early CRC and significantly reduce the levels of serum PGC-1αand SAA,and has a low recurrence rate and residual rate,but it has the limitations of longer operation time and more complications.