Sasaki Fumisato, Mizukami Kazuhiro, Akashi Taro, Yamaguchi Naoyuki, Gushima Ryosuke, Miyamoto Hideaki, Uehara Shohei, Ono Yoichiro, Hisabe Takashi, Kinjo Yuzuru, Nasu Yuichiro, Fukuda Kensuke, Inada Taisuke, Sumida Yorinobu, Akutagawa Takashi, Miike Tadashi, Suzuki Sho, Fukuya Hiroki, Mukasa Michita, Esaki Mitsuru, Kumei Shinsuke, Minoda Yosuke, Kinjo Tetsu, Yamaguchi Daisuke, Fukuda Yoshio, Hashiguchi Kazutoshi, Yano Hiroki, Fujita Hiroshi, Shimoda Ryo
Digestive and Lifestyle Diseases Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima Japan.
Department of Gastroenterology Oita University Oita Japan.
DEN Open. 2025 May 5;6(1):e70102. doi: 10.1002/deo2.70102. eCollection 2026 Apr.
Most esophageal cancers in Japan are squamous cell carcinomas; however, there has been some concern regarding a recent increase in Barrett's esophageal adenocarcinoma (BEA). This study aimed to clarify the clinical characteristics and outcomes of patients treated via endoscopic submucosal dissection (ESD) in Kyushu, including changes over time.
This multicenter, retrospective, observational study was conducted among 21 institutes situated in Kyushu. Data from patients who underwent ESD for BEA or esophageal squamous cell carcinoma between January 2010 and December 2023 were extracted from the pathology database and reviewed.
The total number of esophageal ESD cases increased from 2299 over the first 7 years to 4009 over the second seven. The incidence of BEA increased from 3.6% (86/2299) over the earlier period to 4.7% (197/4009; = 0.034) over the latter. We analyzed data from 283 patients (287 lesions). Smaller tumor-sized lesions were detected over the latter period (14.2 ± 11.6 vs. 11.2 ± 9.5 cm, = 0.022), significantly reducing treatment times (122.1 ± 81.2 vs. 93.2 ± 53.3 min < 0.001). The procedure was safe, with low incidence rates, over both the earlier and later periods (respectively), of perforation (0% vs. 1.0%), delayed bleeding (1.2% vs. 2.0%), and pneumonia (4.7% vs. 4.6%).
The proportion of esophageal ESD procedures to treat BEA has increased in Japan's Kyushu region. This procedure has a comparable safety profile to similar ESD procedures used to treat other conditions.
在日本，大多数食管癌为鳞状细胞癌；然而，近期巴雷特食管腺癌（BEA）的增加引发了一些关注。本研究旨在阐明九州地区接受内镜黏膜下剥离术（ESD）治疗的患者的临床特征和预后，包括随时间的变化。
本多中心、回顾性观察研究在九州的21家机构开展。从病理数据库中提取并回顾了2010年1月至2023年12月期间接受ESD治疗BEA或食管鳞状细胞癌患者的数据。
食管ESD病例总数从最初7年的2299例增加到第二个7年的4009例。BEA的发病率从早期的3.6%（86/2299）增加到后期的4.7%（197/4009；P = 0.034）。我们分析了283例患者（287个病变）的数据。后期检测到的肿瘤大小较小（14.2±11.6 vs. 11.2±9.5 cm，P = 0.022），治疗时间显著缩短（122.1±81.2 vs. 93.2±53.3分钟，P < 0.001）。该手术在早期和后期均安全，穿孔（0% vs. 1.0%）、延迟出血（1.2% vs. 2.0%）和肺炎（4.7% vs. 4.6%）的发生率均较低。
在日本九州地区，治疗BEA的食管ESD手术比例有所增加。该手术的安全性与用于治疗其他疾病的类似ESD手术相当。
