Shimizu Michio, Ban Shinichi, Odze Robert D
Department of Pathology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka City, Saitama 350-1298, Japan.
Gastroenterol Clin North Am. 2007 Dec;36(4):797-811, v-vi. doi: 10.1016/j.gtc.2007.08.005.
Squamous cell carcinoma is the most common tumor of the esophagus worldwide, and it is believed to develop through a sequence of dysplastic precursor lesions, which can be detected both endoscopically and microscopically. There are no published guidelines regarding treatment for dysplasia; however, most authorities recommend increased endoscopic surveillance, with biopsies, for patients with flat low-grade dysplasia and endoscopic mucosal resection, endoscopic submucosal dissection, or esophagectomy for patients with high-grade dysplasia. Future studies are needed to define appropriate endoscopic surveillance frequencies for patients with premalignant lesions of the esophagus. This article discusses squamous dysplasia in detail, which is the most important and well-described risk factor for squamous cell carcinoma of the esophagus.
鳞状细胞癌是全球范围内最常见的食管癌,据信它是通过一系列发育异常的前驱病变发展而来的,这些病变可通过内镜检查和显微镜检查发现。目前尚无关于发育异常治疗的已发表指南;然而,大多数权威机构建议,对于扁平低级别发育异常的患者,增加内镜监测并取活检,对于高级别发育异常的患者,则进行内镜黏膜切除术、内镜黏膜下剥离术或食管切除术。需要进一步的研究来确定食管前驱病变患者合适的内镜监测频率。本文详细讨论了鳞状上皮发育异常,它是食管鳞状细胞癌最重要且描述详尽的危险因素。