ABSTRACT
Objective To investigate the clinical value of multiband mucosectomy (MBM) for the treatment of early esophageal cancer and precancerous lesions.Methods The clinical data of 43 patients with early esophageal cancer or precancerous lesions (including 13 cases of early esophageal cancer and 30 cases of precancerous lesion) who were admitted to the Tengzhou Central People's Hospital from January 2010 to January 2011 were retrospectively analyzed.A total of 51 lesions were confirmed by preoperative endoscopy and mucosal biopsy,and then were treated by MBM.Results A total of 52 MBM procedures were carried out,and 180 lesions were resected.The sizes of the lesions ranged from 10 mm × 8 mm to 25 mm × 23 mm,and the mean operation time was (37 ± 5)minutes.The complete resection rate was 92.2％ (47/51).The submucosal layer of 1 patient was invaded by squamous cell carcinoma postoperatively,and the patient was treated by operation;1 patient wth squamous epithelium carcinoma was treated by radiotherapy at 2 weeks after MBM ; the other 2 lesions were treated by argon plasma coagulation (APC).Four lesions with bleeding were detected during 52 MBM procedures,and no esophageal perforation was detected during MBM.Early complications consisted of delayed bleeding (1 patient,cured by APC) and slight esophageal stenosis (1 patient,recovered at postoperative month 6).The accurate rate of pathological examinations was 51.0％ (26/51).Forty-three patients were followed up for 1 year,3 patients with tumor recurrence were treated by MBM or APC.No death occurred during the followup.Conclusion MBM is a safe and effective technique for the treatment of early esophageal cancer and precancerous lesions.
ABSTRACT
Objective To study the value of using endoscopy iodine staining combined detecting the expression of p53, survivin and telomerase in the diagnosis of early esophageal carcinoma and precancerous lesions. Methods Three hundred patients who received routine gastrescopy and had high risk of esophageal carcinoma were examined by the iodine dyeing on their esophageal mucosa with 2. 5% Lugol solu-tion. Multiple biopsies were taken from the unstained or light-stained areas when their diameters were over 5mm for pathology diagnosis. The expression of p53, survivin and telomerase were detected by immunohistochemical staining. Results With the Lugol staining method, the incidences of light, moderate and high grade dysplasia and early esophageal carcinoma were 16. 3% ,9. 7% ,3.7% and 4. 3% respectively. The expression of p53, survivin and telomerase were related and the unstained were related to the expression of p53, survivin and telomerase in dysplasia and early esophageal carcinoma. Using endoscopy iodine staining combined testing p53, survivin and telomerase showed sensitiv-ity of 100%, specificity of 92. 3% and accuracy of 91.8% to diagnose of early esophageal carcinoma and high grade dysplasia. Conclusion Lugol solution chromoendscopy combined assay of p53, survivin and telomersse might be useful in the diagnosing early esophageal carcino-ma and precancerous lesion.
ABSTRACT
Objective To evaluate the validity of narrow-band imaging (NBI) system in detection of colorectal adenoma, as compared to that of endoscopy of the colon and rectum, in a systematic review. Methods Relevant literatures were retrieved from Medline (January 1966 to October 2008), OVID (January 1996 to October 2008), EMBASE (January 1980 to October 2008), Coehrane Library (Issue 3, 2008) and Chinese Biological Medicine Disk (CBM disk, January 1997 to October 2008). Quality of the literatures retrieved was assessed based on the Cochrane Reviewers' Handbook and Jadad's score. RevMan version 4. 2 software was used for meta-analysis. Results Seven randomized clinical trials (2838 patients) were included in the study. Compared with white-light colonoscopy, no significant difference was observed in terms of adenoma detection rate (OR 1.18, 95% CI 1.00-1.39, P=0.06) by NBI system, which could significantly improve total number of detection for fiat lesions of the colon and rectum (pooled WMD 0.14, 95% CI 0.02-0.26, P=0.02), but with a longer withdrawn time (pooled WMD 1.05, 95% CI 0.08-1.22, P<0.01). Conclusions Detection rate for flat lesions of the colon and rectum, not for adenoma, can be improved by NBI system and meanwhile its withdrawn time is prolonged, indicating that routine use of NBI system for detecting colorectal adenomas may be recommended only with its further refined technique.
ABSTRACT
0.05).The variced recurrence rate in 1- and 2-year were 12% (3/25) and 20% (5/25) in TH glue group,and 39.1% (9/23) and 86.9%(20/23) in control group (P