食管癌液态活检:检测循环游离DNA作为分子标志物是否可行?

食管癌(esophageal cancer,EC)是常见的癌症之一,组织病理类型分为食管鳞状细胞癌和食管腺癌.因确诊晚,并缺乏有效的治疗手段,EC成为世界范围的公共健康问题之一.与常规的肿瘤活检不同,液态活检因损伤性小,可作为传统活检的补充甚至替代方法.尤其是细胞游离DNA(cell-free DNA,cf DNA),...     

食管癌内镜及微创外科治疗进展

<正>尽管存在争议,但部分临床观察已经发现,与传统开放手术相比,食管微创切除手术(minimal invasive esophagectomy,MIE)的术后并发症和病死率不增加,但能减少患者疼痛,有利于患者的术后恢复。随着内镜设备的发展和碘染色广泛应用于上消化道内镜检查,以及内镜下切除技术的进展,早期食管癌内镜下切除术的效果也令人瞩目[1]。掌握食管局部解剖结构和周围淋巴结引流范围对成功完成MIE是     

Comparative study of minimally invasive versus open esophagectomy for esophageal cancer in a single cancer center

Background In order to minimize the injury reaction during the surgery and reduce the morbidity rate,hence reducing the mortality rate of esophagectomy,minimally invasive esophagectomy （MIE） was introduced.The aim of this study was to compare the postoperative outcomes in patients with esophageal squamous cell carcinoma undergoing minimally invasive or open esophagectomy （OE）.Methods The medical records of 176 consecutive patients,who underwent minimally invasive esophagectomy （MIE） between January 2009 and August 2013 in Cancer Institute ＆amp; Hospital,Chinese Academy of Medical Sciences,were retrospectively reviewed.In the same period,142 patients who underwent OE,either Ivor Lewis or McKeown approach,were selected randomly as controls.The clinical variables of paired groups were compared,including age,sex,Charlson score,tumor location,duration of surgery,number of harvested lymph nodes,morbidity rate,the rate of leak,pulmonary morbidity rate,mortality rate,and hospital length of stay （LOS）.Results The number of harvested lymph nodes was not significantly different between MIE group and OE group （median 20 vs.16,P=0.740）.However,patients who underwent MIE had longer operation time than the OE group （375 vs.300 minutes,P 〈0.001）.Overall morbidity,pulmonary morbidity,the rate of leak,in-hospital death,and hospital LOS were not significantly different between MIE and OE groups.Morbidities including anastomotic leak and pulmonary morbidity,inhospital death,hospital LOS,and hospital expenses were not significantly different between MIE and OE groups as well.Conclusions MIE and OE appear equivalent with regard to early oncological outcomes.There is a trend that hospital LOS and hospital expenses are reduced in the MIE group than the OE group.