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对早期食道癌的诊断技术和治疗方法的比较分析:全面的综述
Jinlin Liu1, Min Zhang2, Min Zhu1
1Department of Clinical Medicine, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China.
Frontiers in oncology
|September 18, 2025
概括
早期食道癌 (EC) 管理现在包括器官保存选择,如内镜切除 (ER) 和化疗放射治疗 (CRT). 先进的内镜和风险分层指导治疗选择以改善结果.
科学领域:
- 胃肠道瘤学 胃肠道瘤学
- 消化道癌管理的管理
- 内镜技术 内镜技术
背景情况:
- 食道癌 (EC) 是一个重大的全球健康挑战.
- 早期的EC (pT1a-m3/pT1b) 管理已经超越了手术.
- 器官保存策略,如内镜切除 (ER) 和绝对化疗放射治疗 (dCRT) 是新兴的替代方案.
研究的目的:
- 批判性地评估EC的当代诊断方法.
- 为了比较T1病变的治疗选择 (ER,手术,CRT).
- 建立基于证据的淋巴结转移 (LNM) 风险分层框架.
主要方法:
- 对T1食道病变的治疗选择进行系统评估.
- 对生存结果,并发症和生活质量的比较.
- 复习先进的内镜技术 (例如,ME-NBI) 以实现精确的分期.
- 从关键试验和当前指南中整合数据 (JCOG0502,NCCN).
主要成果:
- 内镜切除 (ER) 证明了手术后的非劣势生存率,具有更好的功能结果 (5年OS 90%vs87%).
- 化学辐射疗法 (CRT) 提供器官保存,但携带更高的狭窄风险 (33%).
- 对于高风险的LNM患者推ER;ER-CRT对降低复发风险有效.
结论:
- 先进的内镜技术对于准确的EC分期至关重要.
- 对LNM的风险分层是选择最佳治疗 (ER与ER-CRT) 的关键.
- 新兴方向包括人工智能增强的诊断和优化的辅助疗法.
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