摘要
目的:对早期结直肠癌及癌前病变的治疗中内镜下黏膜切除术(EMR)、内镜下黏膜剥离术(ESD)的治疗效果进行比较。方法:于2021年1月至2022年6月选取武夷山市立医院收治的早期结直肠癌及癌前病变患者作为研究对象,共计纳入患者80例,通过随机抽签法分为两组,各40例,分别实施EMR(EMR组)、ESD(ESD组)治疗。比较不同治疗方案实施后的效果。结果:EMR组患者术中出血量低于ESD组,手术及住院时间短于ESD组;ESD组患者治愈性切除率、整块切除率高于EMR组,差异均具有统计学意义(P<0.05);两组患者基底病灶残余率比较,差异无统计学意义(P>0.05);ESD组患者血清分化簇3^(+)(CD3^(+))、CD4^(+)水平、CD4^(+)/CD8^(+)高于EMR组;ESD组患者1年复发率、并发症发生率低于EMR组,差异均具有统计学意义(P<0.05),两组患者1年生存率比较,差异无统计学意义(P>0.05);ESD组癌胚抗原相关细胞黏附分子1(CEACAM–1)阳性率低于EMR组,差异具有统计学意义(P<0.05)。结论:对于早期结直肠癌及癌前病变的治疗,ESD病灶切除效率高,可以帮助患者改善细胞免疫功能,有助于患者康复,但手术及住院时间较EMR长,临床可以根据患者实际状况选择最佳治疗方案。
Objective To compare the therapeutic effects of endoscopic mucosal resection(EMR)and endoscopic mucosal dissection(ESD)in the treatment of early colorectal cancer and precancerous lesions.Methods From January 2021 to June 2022,a total of 80 patients with early colorectal cancer and precancerous lesions admitted to Wuyishan City Hospital were selected as the study objects.They were divided into two groups by random drawing method,40 patients in each group,and were respectively treated with EMR(EMR group)and ESD(ESD group).The effects of different treatment schemes were compared.Results The amount of intraoperative blood loss in the EMR group was lower than that in the ESD group,and the duration of operation and hospitalization were shorter than those in the ESD group.The curative resection rate and monolithic resection rate in the ESD group were higher than those in the EMR group,and the differences were statistically significant(P<0.05).There was no significant difference in basal lesion residual rate between the two groups(P>0.05).The levels of serum CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the ESD group were higher than those in the EMR group.The one-year recurrence rate and complication rate of the ESD group were lower than those of the EMR group,the differences were statistically significant(P<0.05),and the one-year survival rate was not statistically significant between the two groups(P>0.05).The positive rate of CEA associated cell adhesion molecule 1(CEACAM-1)in the ESD group was lower than that in the EMR group,and the difference was statistically significant(P<0.05).Conclusion For the treatment of early colorectal cancer and precancerous lesions,ESD lesion resection has high efficiency,which can help patients improve cellular immune function and help patients recover,but the operation and hospital stay are longer than EMR,and the best treatment plan can be selected according to the actual situation of patients.
作者
林微
刘省金
LIN Wei;LIU Shengjin(Wuyishan City Hospital,Fujian Wuyishan 354301)
出处
《深圳中西医结合杂志》
2023年第20期19-22,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
早期结直肠癌
结直肠癌前病变
内镜下黏膜切除术
内镜下黏膜剥离术
Early colorectal cancer
Colorectal precancerous lesions
Endoscopic mucosal resection
Endoscopic mucosal dissection
