经内镜腔内冷冻后手术治疗食管癌  

Preoperative endoscopic cryotherapy plus surgery for esophageal cancer

作　　者：杨瑞森[1] 刘奇[1] 张百江[1] 张兴国[1] 张为迪[1] 

机构地区：[1]山东省肿瘤医院,250117

出　　处：《中华消化内镜杂志》2000年第6期333-335,共3页Chinese Journal of Digestive Endoscopy

摘　　要：目的观察腔内冷冻加手术切除能否提高食管癌的 5年生存率。方法采用随机分组的方法，将入院手术的食管癌患者 50例分成两组：冷冻治疗组 25例，先于术前经内镜行食管腔内冷冻，再行手术切除；对照组 25例常规行食管癌切除术。观察冷冻组患者术中所见、手术标本的病理学改变及冷冻前后各项免疫指标的变化。分别统计两组 1、 3、 5年生存率。结果冷冻组术中见病变周围 1～ 2站淋巴结多呈融合状；电镜检查 5例，显示冷冻后大部分癌细胞破损；冷冻后患者的补体 C3、淋巴细胞转化率提高。冷冻治疗组 1、 3、 5年生存率分别为 92％、 76％、 56％，对照组分别为 80％、 40％、 28％，经统计学处理，两组 1年生存率差异无统计学意义， 3年、 5年生存率冷冻治疗组高于对照组，差异有统计学意义。结论术前冷冻可降低淋巴结的转移率，提高患者的免疫功能，可望提高患者的 5年生存率。Objective Wether preoperative freezing plus traditional operative resection would improve 5 year survival of patient with esophageal cancer was studied. Methods 50 patients admitted for esophageal cancer were divided equally at random.The treatment group (n=25) received cryotherapy before traditional surgery.The rest,without pretreatment,had surgery as controls.Their 1,3,5 year survival rates were contrasted. Results With pretreatment the 1,3,5 year survival rate reached 92,76,56 percent respectively,while that of the controls attained 80,40,and 28 percent accordingly.Statistically significant difference in survival did exist between groups by the end of 3 and 5 years after the combined therapy, yet no difference was detected within 1 year. Conclusion Preoperative cryotherapy could reduce the possibility of lymphatic metastasis,iatrogenic spread during operation and improve patient’ s immunological functions and life span.

关 键 词：食管癌 冷冻治疗 

分 类 号：R735.1[医药卫生—肿瘤] R730.56[医药卫生—临床医学]