早期贲门癌内镜下诊断与治疗  

Endoscopic diagnosis and treatment of the early adenocarcinoma of esophagogastric junction

作　　者：张月明[1] 王瑞刚[1] 王贵齐[1] 

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院内镜科,北京100021

出　　处：《中国医学前沿杂志（电子版）》2017年第5期23-28,共6页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金："十三五"国家重点研发计划项目(重大慢性非传染性疾病防控研究)(2016YFC1302800)

摘　　要：贲门癌在我国的发病率呈上升态势,防控形势十分严峻。由于贲门癌早期症状不明显,超过90%的患者就诊时已属中晚期,而中晚期贲门癌患者的5年生存率不足20%。再者,贲门活检取材困难,早期检出率很低,影响了患者接受根治性治疗的可能性和治疗效果。随着人们对自身健康的重视和内镜诊断水平的进步,特别是色素内镜、放大内镜及超声内镜等技术的发展,使早期贲门癌和癌前病变检出率逐渐提高。而且,大部分早期贲门癌在内镜下即可获得根治性治疗,患者5年生存率超过90%。目前,内镜下黏膜切除术(endoscopic mucosal resection,EMR)和内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)已被证实是治疗早期贲门癌安全、有效的内镜下微创治疗技术。本文就早期贲门癌的内镜下诊断与治疗的临床应用及发展现状进行综述。With a serious prevention and control situation, the incidence of adenocarcinoma of esophago-gastric junction in China is rising. Because the early symptoms is not obvious, more than 90% patients with adenocarcinoma of esophagogastric junction has been found in the advanced stage, 5-year survival rate is less than 20%. Moreover, the endoscopic biopsy from esophageal junctional is difficult, early detection rate is very low, affecting the patient to accept the possibility of radical treatment. With the emphasis on their own health and the progress of endoscopic diagnosis, especially chromoendoscopy, magnifying endoscopy and endoscopic ultrasoundand other technology development, the early adenocarcinoma of esophagogastric junction and precancerous lesions detection rate gradually increased. Most early EGJ cancer could be radically resected by endoscopic minimally invasive treatment, and 5-year survival rate is more than 90%. Currently, endoscopic mucosal resection （EMR） and endoscopic submucosal dissection （ESD） have been shown to be safe and effective endoscopic minimally invasive treatment technology. This article discusses the clinical application and development of endoscopic diagnosis and treatment.

关 键 词：早期 食管胃结合部腺癌 内镜下黏膜切除术 内镜黏膜下剥离术 

分 类 号：R735[医药卫生—肿瘤]