超声内镜辅助下内镜黏膜下切除术对食管癌前病变患者肿瘤标志物及应激反应指标的影响  

Effect of Endoscopic Submucosal Resection Assisted by Endoscopic Ultrasonography on Tumor Markers and Stress Response Indexes in Patients with Esophageal Precancerous Lesions

作　　者：王百惠 宋艳君[1] 王秀娟[2] 王青[1] 李如源 WANG Bai-hui;SONG Yan-jun;WANG Xiu-juan;WANG Qing;LI Ru-yuan(Department of Gastroenterology,Qilu Hospital of Shandong University,Jinan,Shandong,250012,China;Department of Gastroenterology,Qingdao Eighth People's Hospital,Qingdao,Shandong,266000,China)

机构地区：[1]山东大学齐鲁医院消化内科,山东济南250012 [2]青岛市第八人民医院消化内科,山东青岛266000

出　　处：《现代生物医学进展》2019年第19期3661-3664,3605,共5页Progress in Modern Biomedicine

基　　金：山东省医药卫生科技发展计划项目(2015SW0319)

摘　　要：目的:探讨超声内镜(EUS)辅助下内镜黏膜下切除术(EMR)对食管癌前病变患者肿瘤标志物及应激反应指标的影响。方法:选择山东大学齐鲁医院青岛院区消化内科于2016年3月至2018年4月期间收治的食管癌前病变患者137例,采用随机数字表法将患者分为常规组(n=68,常规胃镜下行EMR)和EUS组(n=69,EUS辅助下行EMR),比较两组患者临床指标,比较两组术前、术后血清肿瘤标志物及应激反应指标水平,比较两组术前、术后1周相关遗传学分子水平。结果:EUS组手术时间、术后流质饮食时间均短于常规组(P<0.05),并发食管黏膜小穿孔例数、使用钛夹止血例数均少于常规组(P<0.05)。两组患者术后肿瘤特异性生长因子(TSGF)、细胞角蛋白19血清片段21-1(CYFRA21-1)、鳞状上皮细胞癌抗原(SCC-Ag)均较术前升高,但EUS组低于常规组(P<0.05)。两组患者术后肾上腺素(E)、去甲肾上腺素(NE)、肾素(R)、血管紧张素Ⅱ(AngⅡ)、醛固酮均较术前升高,但EUS组低于常规组(P<0.05)。两组患者术后1周细胞周期素E(Cyclin E)、转化生长因子-α(TGF-α)均较术前降低,且EUS组低于常规组(P<0.05)。结论:相比于常规胃镜,经EUS辅助下EMR治疗食管癌前病变可有效改善患者的临床指标,减轻患者应激反应,有利于降低血清肿瘤标志物及遗传学分子水平。Objective: To investigate the effect of endoscopic submucosal resection(EMR) assisted by endoscopic ultrasonography(EUS) on tumor markers and stress response indexes in patients with esophageal precancerous lesions. Methods: A total of 137 patients with esophageal precancerous lesions, who were admitted to Gastroenterology Department of Qilu Hospital Qingdao District of Shandong University from March 2016 to April 2018, were selected. The patients were divided into routine group(n=68, routine gastroscopy EMR) and EUS group(n=69, EUS-assisted EMR). The clinical indicators, the serum tumor markers and stress response indexes before operation and after operation, and the genetic molecules levels before operation and 1 weeks after operation were compared between the two groups. Results: The operation time and the fluid diet time of EUS group were shorter than those of routine group(P<0.05),and the number of small perforation of esophageal mucosa and hemostasis with titanium clip were less than those of routine group(P<0.05).The levels of tumor specific growth factor(TSGF), cytokeratin 19 serum fragment 21-1(CYFRA21-1) and squamous cell carcinoma antigen(SCC-Ag) in both groups were higher than those before operation, but the above indexes in EUS group were lower than those in routine group(P<0.05). Postoperative levels of epinephrine(E), norepinephrine(NE), renin(R), angiotensin II(Ang II) and aldosterone in both groups were higher than those before operation, but the above indexes in EUS group were lower than those in routine group(P<0.05).The cyclin E(Cyclin E) and transforming growth factor-α(TGF-α) 1 week after operation in the two groups were lower than before operation, and the above indexes in EUS group were lower than those in routine group(P<0.05). Conclusion: Compared with routine gastroscopy, EMR assisted by EUS, in the treatment of esophageal precancerous lesions, can effectively improve the clinical indicators, alleviate the stress response of patients, and reduce the level of serum tumor markers and ge

关 键 词：超声内镜 内镜黏膜下切除术 食管癌前病变 肿瘤标志物 应激反应 

分 类 号：R735.1[医药卫生—肿瘤]