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首页> 外文期刊>Annals of the New York Academy of Sciences >Pathologic assessment of endoscopic resection specimens with superficial carcinoma of the esophagus: current practice and practical issues
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Pathologic assessment of endoscopic resection specimens with superficial carcinoma of the esophagus: current practice and practical issues

机译：食管浅表癌的内镜切除标本的病理学评估：当前的实践与实际问题

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摘要

Endoscopic resection (ER) has become the first-line therapy for early esophageal cancer and offers a treatment alternative to surgery, owing to less morbidity and better quality of life. ER techniques include endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). EMR is faster, simpler, and cheaper than ESD, but limited by its ability to resect lesions larger than 1.5 centimeters. Piecemeal EMR has limitations, including a high local recurrence rate and a suboptimal specimen for an accurate pathologic assessment. ESD, on the other hand, allowsen blocresections with negative (R0) margins, irrespective of lesion size, providing an excellent pathologic specimen, however, is technically challenging with a higher risk of complications. The evaluation of ER specimens in pathology varies slightly from institution to institution. Our review summarizes the current practices and issues in the pathologic assessment of esophageal ER specimens, which highlights the necessity of a systematic approach and standardization of both macroscopic and microscopic evaluation. There is a need for a comprehensive and standardized pathology report that will allow for uniform terminology for endoscopists, surgeons, and pathologists, which, in turn, will result in better treatment guidance.
机译：内镜切除（ER）已成为早期食管癌的一线治疗，并提供治疗替代手术，由于发病率较小，更好的生活质量。 ER技术包括内窥镜粘膜切除（EMR）和内窥镜粘膜释放剖检（ESD）。 EMR比ESD更快，更简单，更便宜，但能够通过其切割大于1.5厘米的病变的能力有限。零碎的EMR具有局限性，包括高局部复发率和用于准确病理评估的次优次数。另一方面，ESD允许具有负（R0）边距的抗体的细分，而不管病变大小，提供优异的病理标本，在技术上挑战并发症的风险较高。对病理学中的ER标本的评估略有不同于机构的机构。我们的审查总结了食管ER标本的病理评估目前的实践和问题，这突出了宏观和微观评估的系统方法和标准化的必要性。需要一个全面和标准化的病理学报告，可以允许内窥镜师，外科医生和病理学家统一术语，这反过来又会导致更好的治疗指导。

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