氩离子热凝固术治疗癌前病变和早期食管癌的远期效果  

Long-term outcomes of endoscopic argon plasma coagulation （APC） therapy for early esophageal cancer and precancerous lesions

作　　者：王国清[1] 郝长青[3] 魏文强[2] 赵琳[2] 

机构地区：[1]100021中国医学科学院北京协和医学院肿瘤医院内镜科 [2]100021中国医学科学院北京协和医学院流行病室 [3]河南省林州市肿瘤医院内镜科

出　　处：《中华肿瘤杂志》2013年第6期456-458,共3页Chinese Journal of Oncology

摘　　要：目的评价内镜下氩离子热凝固术（APC）治疗癌前病变和早期食管癌的远期效果。方法1994年至2005年间，采用APC治疗171例癌前病变和早期食管癌患者，随访观察其长期生存情况。168例（98．2％）接受了多次内镜复查，平均每例2．8次。随访率为100％。结果癌前病变者160例，随访5年，死于非癌疾病11例，发展为食管鳞癌5例（死亡2例，行食管切除术3例），无癌生存144例。癌前病变者经APC治疗后的癌变率仅为3．1％（5／160）。早期食管癌11例，随访5年，死于非癌疾病2例，食管癌复发6例（死亡4例，接受食管切除术2例），无癌生存3例。早期食管癌经APC治疗后的5年治愈率为27．3％（3／11）。结论APC治疗食管癌前病变是有效和成功的，但应用APC治疗早期食管癌（如黏膜内癌）应严格掌握其适应证。Objective To evaluate the long-term outcomes of endoscopic argon plasma coagulation （APC） therapy for early esophageal cancer and precancerous lesions. Methods One-hundred and seventy- one cases with early esophageal cancer （intramucosal carcinoma） and precancerous lesions were treated by APC from 1994 to 2005, and all the cases were followed up. One-hundred and sixty-eight （98.2%） cases were follow-up by endoscopic examination for several times. On average, each patient was endoscopically examined 2.8 times. The follow-up rate was 100%. Results The precancerous lesion group had 160 patients. They were followed up for 5 years. 11 patients died of causes unrelated to cancer. The lesions developed into esophageal squamous cell carcinoma in five patients （ 2 died and 3 underwent esophagectomy）. The remaining 144 cases survived without cancer. In this group, the esophageal cancer incidence rate is only 3.1% （5/160）. The early cancer （i. e. intramucosal cancer） group had 11 patients. During the 5-year follow-up period, two patients died of causes unrelated to cancer, six patients had recurrence （4 patients died and 2 patients underwent esophagectomy）, and only 3 patients survived without cancer. Therefore, the 5-year survival rate was only 27.3% （3/11）. Conclusions The APC therapy for precancerous lesions of the esophagus is effective and successful. Indications should be carefully considered when treating early esophageal cancer such as intramucosal carcinoma by APC therapy.

关 键 词：食管肿瘤 癌前病变 氩离子热凝固术 

分 类 号：R735[医药卫生—肿瘤]