早期食管癌及癌前病变EUS的诊断价值及EMR治疗的临床研究  

Diagnostic value of EUS and therapeutic value of EMR in early esophageal cancer and precancerous lesions

作　　者：朱萱[1] 李弼民[1] 刘志坚[1] 李国华[1] 张小茜[1] 王剑[1] 何怀纯[1] 

机构地区：[1]南昌大学第一附属医院消化科,南昌330006

出　　处：《江西医药》2010年第5期393-396,共4页Jiangxi Medical Journal

基　　金：江西省科技厅课题论文

摘　　要：目的探讨超声内镜(endocopic ultrasonography,EUS)在判断早期食管癌浸润深度及内镜下黏膜切除术(endoscopic mucosal resection,EMR)在早期食管癌及癌前病变中的治疗价值。方法对经常规胃镜检查明确为食管癌及癌前病变的患者进行EUS检查,观察病灶浸润深度,对符合行EMR治疗指征的患者分为外科手术治疗组及EMR治疗组,术后病理病灶浸润深度与EUS检查比较;对外科治疗组与EMR治疗组两组之间病人治疗效果进行比较。结果 EUS对食管癌浸润深度判断的准确率为85.7%,早期食管癌及癌前病变EMR治疗组和外科手术组相比,术后并发症、病灶完全切除率、术后生存率、术后病灶复发率无统计学差别(P>0.05);EMR治疗组患者在住院时间、术后恢复时间及住院费用低于手术组(P<0.05)。结论EUS在判断食管癌浸润深度中准确率高,EMR在早期食管癌及癌前病变中的治疗价值优于外科手术治疗。Objective To explore diagnostic value of EUS and therapeutic value of endoscopic mucosal resection（EMR）on patients with early esophageal cancer and precancerous lesion.Methods EUS was performed on patients in our hospital diagnosed as esophageal cancer or precancerous lesions by conventional endoscopy,and observed the depth of tumor infiltration;the patients have surgical indications of EMR were divided into surgical group and the EMR group,the depth of tumor infiltration was compared between the pathological result of postoperative and the result of EUS examination,and the therapeutic effect was compared between two groups.Results The accurate rate of EUS in assessing the depth of esophageal cancer infiltration was 85.7 %.There are no statistical differences between EMR group and surgery group in early esophageal cancer and precancerous lesions in the incidence of postoperative complications,tumor complete resection rate,survival rate,postoperative recurrence of lesions（P〉0.05）;EMR treatment group were lower than surgical group in hospitalization time,postoperative recovery time and hospitalization costs（P〈0.05）.Conclusion EUS has a high accuracy rate in assessing the depth of tumor infiltration,the therapeutic value of EMR is better than surgery in early esophageal cancer and precancerous lesions.

关 键 词：早期食管癌 癌前病变 EUS EMR 

分 类 号：R735.1[医药卫生—肿瘤]