CHAPEL HILL, NORTH CAROLINA.
Trans Am Clin Climatol Assoc. 2020;131:297-314.
Traditional therapy for early esophageal neoplasia has been esophagectomy. In the past decade, the approach to these conditions has rapidly evolved, such that endoscopic therapy has become the primary modality to treat patients with esophageal dysplasia and superficial carcinoma. A variety of modalities are available, including thermal methods, such as radiofrequency ablation and argon plasma coagulation; cryotherapy, including spray liquid nitrogen cryotherapy and balloon-based nitrous oxide cryotherapy; and tissue resection methods, such as endoscopic mucosal resection and endoscopic submucosal dissection. Level 1 evidence substantiates that patients treated with these therapies have a low risk of developing invasive cancer. These treatments demonstrate an excellent safety profile. Future work in this area will define the best modalities of treatment, assess the utility of endoscopic therapy in combination with radiation therapy and chemotherapy, and improve current screening regimens to allow earlier detection of neoplasia.
传统的早期食管肿瘤治疗方法为食管切除术。在过去的十年中，这些疾病的治疗方法迅速发展，内镜治疗已成为治疗食管发育不良和表浅癌患者的主要手段。有多种方法可供选择，包括热疗方法，如射频消融和氩等离子凝固；冷冻疗法，包括喷洒液氮冷冻疗法和基于气囊的一氧化二氮冷冻疗法；以及组织切除方法，如内镜黏膜切除术和内镜黏膜下剥离术。一级证据证实，接受这些治疗的患者发生浸润性癌症的风险较低。这些治疗方法具有极好的安全性。该领域的未来工作将确定最佳的治疗方式，评估内镜治疗联合放化疗的效用，并改进现有的筛查方案，以更早地发现肿瘤。
