Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
Gastroenterol Clin North Am. 2021 Dec;50(4):791-808. doi: 10.1016/j.gtc.2021.07.004. Epub 2021 Oct 6.
Endoscopic findings in early esophageal cancer are often subtle and require careful inspection and meticulous endoscopic examination. When dysplasia is suspected, we recommend performing 1 or 2 targeted biopsies of the abnormal area and review with a pathologist specialized in evaluating gastrointestinal diseases. In the case of adenocarcinoma, after resection of any visible cancer, residual Barrett's can be treated by ablation. Endoscopic resection can offer the opportunity for patients to avoid surgery. Further studies are needed to evaluate the optimal management of circumferential and near-circumferential lesions as well as tools and techniques to facilitate the performance of endoscopic submucosal dissection and endoscopic mucosal resection.
早期食管癌的内镜表现往往不明显，需要仔细观察和精心的内镜检查。当怀疑有异型增生时，我们建议对异常区域进行 1 或 2 次靶向活检，并由专门评估胃肠道疾病的病理学家进行复查。对于腺癌，在切除任何可见的癌症后，残余的 Barrett 食管可以通过消融来治疗。内镜下切除可以为患者提供避免手术的机会。需要进一步的研究来评估环周和近环周病变的最佳治疗方法，以及有助于进行内镜黏膜下剥离术和内镜黏膜切除术的工具和技术。
