Yuan Xiao-Chen, Jia Ping, Tian Tian, Zhu Jun, Zhang Xiao-Yan
Department of Gastroenterology, The Affiliated Taizhou Second People's Hospital of Yangzhou University, Taizhou 225300, Jiangsu Province, China.
Department of Laboratory Medicine, The Affiliated Taizhou Second People's Hospital of Yangzhou University, Taizhou 225300, Jiangsu Province, China.
World J Gastrointest Surg. 2025 Apr 27;17(4):103700. doi: 10.4240/wjgs.v17.i4.103700.
Tumor progression in patients with esophageal precancerous lesions (EPLs) or early esophageal carcinoma (EEC) is typically confined in both extent and location. Prompt and effective intervention significantly improves treatment outcomes and prognosis for these individuals.
To determine the effect of endoscopic submucosal dissection (ESD) on efficacy, serum tumor markers (STMs), and 6-month postoperative recurrence rate in patients with either EPL or EEC.
This study initially enrolled 120 patients with EPL or EEC, who were admitted from April 2021 to April 2024. Participants were divided into the control group (60 cases), which underwent thoracotomy, and the research group (60 cases) which received ESD treatment. The comparative analysis involved information regarding the efficacy (dissection area and resection rate per unit time), complications (delayed bleeding, wound infection, esophageal reflux, and postoperative esophageal stenosis), surgery-related parameters (bleeding volume, operation duration, and hospital length of stay), STMs [carcinoembryonic antigen (CEA), carbohydrate antigen 724 (CA724), and tumor-specific growth factor (TSGF)], and the 6-month postoperative recurrence rate of the two groups.
Data indicated statistically higher dissection area and resection rate per unit of time in the research group than in the control group. Meanwhile, the research group demonstrated a notably lower overall incidence rate of complications, bleeding volume, operation duration, and hospital length of stay. Further, the CEA, CA724, and TSGF were markedly reduced in the research group after treatment, which were statistically lower compared to the baseline and those of the control group. Finally, during the follow-up, a comparable 6-month postoperative recurrence rate was determined in the two groups.
ESD is clinically effective and safe for EPL and EEC and can significantly restore abnormally increased levels of STMs.
食管癌前病变（EPL）或早期食管癌（EEC）患者的肿瘤进展通常在范围和位置上都受到限制。及时有效的干预可显著改善这些患者的治疗效果和预后。
确定内镜黏膜下剥离术（ESD）对EPL或EEC患者疗效、血清肿瘤标志物（STM）及术后6个月复发率的影响。
本研究最初纳入2021年4月至2024年4月收治的120例EPL或EEC患者。参与者分为对照组（60例），接受开胸手术；研究组（60例），接受ESD治疗。比较分析包括疗效（单位时间内剥离面积和切除率）、并发症（迟发性出血、伤口感染、食管反流和术后食管狭窄）、手术相关参数（出血量、手术时间和住院时间）、STM[癌胚抗原（CEA）、糖类抗原724（CA724）和肿瘤特异性生长因子（TSGF）]以及两组术后6个月复发率等信息。
数据表明，研究组单位时间内的剥离面积和切除率在统计学上高于对照组。同时，研究组的并发症总发生率、出血量、手术时间和住院时间明显更低。此外，研究组治疗后CEA、CA724和TSGF显著降低，与基线水平及对照组相比差异有统计学意义。最后，随访期间，两组术后6个月复发率相当。
ESD治疗EPL和EEC在临床是有效且安全的，并且能显著恢复异常升高的STM水平。
