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在恶性胃肠病变的先进内镜切除中扩大了治疗指标
Fredy Nehme1, George M Wahba2, Phillip S Ge3
1Indiana University School of Medicine, Indianapolis, IN, USA.
Current gastroenterology reports
|February 3, 2026
概括
内镜切除 (ER) 正在扩大早期胃肠道癌症,提供器官保存和低发病率. 先进的技术和风险分层使得选择患者的结果与手术相提并论.
科学领域:
- 胃肠道学和瘤学
- 最少侵入性的手术
背景情况:
- 内镜切除 (ER) 彻底改变了早期胃肠道 (GI) 恶性瘤管理,优先考虑器官保存和降低发病率.
- 从历史上看,ER仅限于具有最小淋巴结转移 (LNM) 风险的粘膜病变.
- 最近的技术和风险分层进展需要重新评估ER在食道,胃和结肠直肠癌中的作用.
研究的目的:
- 审查在肠道恶性瘤中扩大ER指示的瘤学理由.
- 总结目前支持更广泛使用ER的证据.
- 讨论有助于安全ER扩张的新兴技术.
主要方法:
- 审查关于内镜切除技术和结果的当前文献.
- 对组织病理学标准和风险分层工具的分析.
- 评估新兴技术,如人工智能和分子生物标志物.
主要成果:
- 精细的标准和技术 (例如,内镜下膜剖析,全厚切除) 允许在选择的早期胃肠道癌症中治疗ER.
- 当严格的选择和监测被应用时,结果与手术竞争,患病率较低.
- 人工智能,分子生物标志物和哨兵节点映射显示LNM风险评估的希望.
结论:
- 扩大早期胃肠道癌的ER指示是可行的,并且越来越多地被专家中心采用,实现了类似手术的结果.
- 整合精确诊断,分子分析和人工智能可以进一步完善患者选择.
- 广泛采用需要基于证据的框架,以确保瘤学完整性和防止治疗不足.
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