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首页> 外文期刊>Current opinion in gastroenterology >Diagnosis and treatment of early esophageal cancer.
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Diagnosis and treatment of early esophageal cancer.

机译：早期食道癌的诊断和治疗。

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PURPOSE OF REVIEW: Increasing numbers of early esophageal neoplasias (especially Barrett's cancer) are being detected in Western countries, so that endoscopic therapy with a curative intent plays an increasing role. RECENT FINDINGS: Technological advances in endoscope development and auxiliary techniques such as chromoendoscopy increase the detection rate of early esophageal neoplasias. In all localizable lesions (high-grade intraepithelial neoplasia and mucosal cancers), the treatment of choice is endoscopic resection, which allows histological assessment. Photodynamic therapy with 5-aminolevulinic acid is suitable mainly in nonlocalizable neoplasias. Intensive photodynamic therapy with porfimer sodium should not be used, due to the high complication rate. The rationale for endoscopic therapy is that there is a very low risk of lymph-node metastasis in mucosal carcinomas, lower than the mortality risk with surgery. Surveillance of these endoscopically treated patients is absolutely necessary to detectrecurrent or metachronous lesions, which can again be treated endoscopically. SUMMARY: Careful staging is indispensable before curative endoscopic therapy, as is consistent and careful follow-up. Endoscopic therapy is safe and effective, and endoscopic resection is the treatment of choice. Endoscopic therapy can replace radical esophageal resection in early mucosal esophageal carcinoma (at least in lesions with good to moderate differentiation and no lymph-node invasion).
机译：审查的目的：在西方国家，越来越多的早期食道肿瘤（尤其是巴雷特癌）被发现，因此具有治愈意图的内窥镜治疗起着越来越重要的作用。最近的发现：内窥镜开发的技术进步以及诸如色内镜的辅助技术提高了早期食道肿瘤的检出率。在所有可定位的病变中（高度上皮内瘤变和粘膜癌），选择的治疗方法是内镜下切除术，这可以进行组织学评估。 5-氨基乙酰丙酸的光动力疗法主要适用于非局限性肿瘤。由于高并发症发生率，不应该使用使用porfimer钠的强化光动力疗法。内窥镜治疗的基本原理是粘膜癌中淋巴结转移的风险非常低，低于手术导致的死亡风险。对这些经内镜治疗的患者进行监视对于检测复发性或异时性病变是绝对必要的，可以通过内镜再次治疗。总结：在根治性内镜治疗之前，仔细的分期是必不可少的，因为这是一致且仔细的随访。内镜治疗是安全有效的，内镜切除术是首选治疗方法。内镜治疗可以代替早期食管黏膜食管癌的根治性食管切除术（至少在具有良好至中度分化且无淋巴结浸润的病变中）。

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