Objective To formulate an evidence-based practice for the patient with superficial esophageal cancer. Methods After some clinical problems about the diagnosis and treatment of superficial esophageal cancer being proposed, the latest clinical guidelines were found on the websites (www.guideline.org, www.nccn.org), and the Ovid databases(ALL EBM reviews, MEDLINE) (1950 to Feb 2011), Web of Knowledge( 1900 to Feb 2011), PubMed (1970 to Feb2011) and CNKI (1976 to Feb 2011)were searched to collect the relevant evidences. The validity, reliability and feasibility of each study were evaluated to select the current best evidences. Results A total of 24 documents were qualified, including 2 systematic reviews (SRs), 2 meta-analyses, 2 guidelines and 1 randomized controlled trial (RCT). According to the current evidences and the patient's preference, the diagnosis of esophageal cancer was established by flexible endoscopy and biopsy, and endoscopic submucosal dissection (ESD) technique was safe and effective for this patient.Whereas chemoradiotherapy was not suitable for him. The patient's symptoms were relieved after two weeks of treatment. Two years of follow-up indicated the practice was suitable for this patient. Conclusions Multiple diagnostic methods should be applied to identify the early stage of esophageal cancer. The current evidences suggest that endoscopic surveillance following ESD therapy is an effective strategy to treat this kind of patients.%目的 介绍浅表性食管癌患者的循证处理方案.方法 针对患者的临床问题,首先在www.guideline.org和www.nccn.org网站上检索了最新的临床指南,然后检索了Ovid (ALL EBM reviews,MEDLINE)(1950年至2011年2月)、Web of Knowledge(1900年至2011年2月)、PubMed(1970年至2011年2月)和CNKI(1976年至2011年2月)等数据库中有关浅表性食管癌诊断和治疗相关的文献,并评价其真实性、重要性和适用性以获取最佳证据.结果 共检索到24篇文献,其中包括2篇Cochrane系统评价、2篇Meta分析、2篇指南和1篇随机对照试验.根据现有证据及患者意愿,浅表性食管癌诊断首选胃镜加活组织检查,经内镜黏膜下剥除术对该患者是安全和有效的,不推荐行放疗化疗等辅助疗法.治疗2周后症状明显改善.经过2年的随访,证实所选方案适合患者.结论 应采取多种诊断手段来鉴定早期食管癌.目前的循证医学证据表明对于这类病人行经内镜黏膜下剥除术和内镜随访是一种有效的处理策略.
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