食管癌围手术期治疗的研究现状和进展

食管癌是我国常见的恶性肿瘤之一。西方国家以腺癌为主，亚洲地区则以鳞癌为主，我国食管癌中鳞癌患者约占95％。手术为食管癌的主要治疗方法，但单纯手术的效果并不尽如人意，5年生存率不足30％。为了提高手术效果，国内外很多研究探索了手术联合围手术期治疗的综合治疗模式。目前认为，在确保疗前准确分期的基础上，对于Ⅰ期及ⅡA期的患者可直接行手术治疗；对于ⅡB期及Ⅲ期的患者可行新辅助化疗或同步放化疗后进行手术。关于术后辅助治疗，目前尚缺乏有力的循证医学证据支持，但一些研究已初步证实术后辅助治疗的有效性。此外，围手术期分子靶向药物的应用及新辅助治疗疗效预测因子的研究也越来越成为研究的热点。

Current status and progress of perioperative treatment of esophageal cancer

Esophageal cancer is a highly lethal and aggressive gastrointestinal cancer nationwide. Esophageal squamous cell carcinoma（SCC） is endemic in Asian countries， while adenocarcinoma is more common in western countries. In China， SCC accounted for 95％ of esophageal carcinoma. Surgery is the main treatment method for esophageal cancer. However， the results of surgery alone have been dissatisfactory， with survival rates of approximately 30％ at 5 years. So， new combinations of different protocols have been investigated by many trials. According to accurate preoperative staging， stage Ⅰ and ⅡA esophageal cancer is suitable for direct surgery， while stage ⅡB and Ⅲ should be primarily treated with neoadjuvant chemotherapy or chemoradiation followed by surgery. Adjuvant treatment maybe helpful to improve the outcomes of patients， but it still needs further studies. Furthermore， molecular targeted therapy and predictors for neoadjuvant treatment are increasingly becoming research hotspots of esophageal cancer.