ABSTRACT
To explore the application value of pushing endoscopic submucosal dissection (PESD) in treatment of large area of early cardiac cancer or precancerous lesions. Form January 2017 to January 2020, patients diagnosed as having early cardiac cancer or high-grade intraepithelial neoplasia with largest lesion diameter greater than 2.0 cm at the Baoding NO.1 Central Hospital were enrolled in the study. Patients who received PESD with water-injected knife were included in the PESD group (26 cases), and compared with those who received conventional ESD with common mucosal incision (the conventional ESD group, 17 cases) at the same period. The procedure time, the complete resection rate of lesions and the incidence of complications were analyzed.There were no difference in lesion size between the two groups ( P>0.05). The procedure time of PESD group was 53.7±18.2 min, which was 91.5±26.5 min in the conventional ESD group, and the difference was statistically significant ( P<0.001). In the PESD group, 7 cases (26.9%) had intraoperative hemorrhage. In the conventional ESD group, 8 cases (47.1%) had intraoperative bleeding, and 2 (11.8%) had intraoperative perforation. There were significant differences in the incidence of hemorrhage and perforation between the two groups (all P<0.001). Compared with conventional ESD, PESD can effectively improve the dissection speed, reduce the incidence of complications, and make endoscopic surgery safer and faster.
ABSTRACT
?At present, the diagnosis and treatment of early cancer in digestive tract is a hot topic, which is defined as cancer confined to the mucosa layer and submucosa, including early esophageal cancer, early gastric cancer and early colorectal cancer. For gastrointestinal cancer early diagnosis technology has been from a single common white light endoscopy, endoscopic gradually transition to the pigment dyeing narrow-band imaging technology, electronic (narrow band imaging, NBI), intelligent electronic spectroscopic techniques (flexible spectral imaging color enhancement, FICE), magnifying endoscopy, endoscopic confocal optical microscopy, confocal laser endomicroscopy, CLE), etc., so as to improve the early cancer detection rate, can even provide lesions in depth and scope, histopathology, and blue laser endoscope is introduced by the Fuji company blue laser endoscopic system (LASEREO), the more possibility for accurate diagnosis of early carcinoma of digestive tract. In this paper, the progress of blue laser imaging technology (blue laser imaging, BLI) in the accurate diagnosis of early carcinoma of digestive tract was overviewed.
ABSTRACT
El canal anal es la porción distal del tracto digestivo y mide entre 2,5 a 4 cm. de longitud. El cáncer del canal anal es una enfermedad relativamente rara, siendo el carcinoma de células escamosas el más frecuente, con una sobrevida de 5 años de aproximadamente 58%. En los años recientes existe un aumento en la incidencia y prevalencia de la neoplasia intraepitelial y del cáncer del canal anal. El diagnóstico temprano de la neoplasia intraepitelial y del cáncer precóz del canal anal, permite una adecuada estrategia terapéutica curativa. La endoscopia mediante la técnica de la cromoendoscopia virtual y magnificación endoscópica, logra la detección y caracterización de la neoplasia intraepitelial y del carcinoma precoz de células escamosas del canal anal, mediante la observación de las alteraciones en la arquitectura microvascular subepitelial, con alta seguridad diagnóstica. Se presenta la experiencia con 4 pacientes con carcinoma precóz de células escamosas del canal anal, detectados por cromoendoscopia virtual + magnificación y su correlación endoscópica e histológica.
The anal canal is the terminal portion of the digestive tract. The anal canal is 2.5 to 4cm in lenght. The cancer of anal canal is a relatively rare malignancy and the most frequent is the type squamous cell carcinoma, accounting for a 5 year survival of 58 %. The endoscopic evaluation of microvascular pattern of superficial lesions of the anal canal, by virtual chromoendoscopy and magnifying endoscopy, achieves the diagnosis of intraepithelial neoplasia and early squamous cell carcinoma of the anal canal. Here we report our experience in 4 patients with early squamous cell carcinoma and show the endoscopy-histopathological correlation. The early diagnosis of the disease, permit curative treatment with local resection.
ABSTRACT
Twenty cases of gallbladder cancers were examined using 5 mm stepwise tissue sections. We analyzed the clinicopathologic findings of the early (stage 1, II) and advanced carcinoma (stage III, IV, V) and those of carcinoma with or without metaplasia in the tumor. We also performed CEA and p53 immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. The results were as follow: 1) All of the early carcinomas (n=5) were incidentally diagnosed after the resection for the gallstone. They were compared to advanced carcinoma (n=15) in the absence of the lymphatic or angioinvasion, recurrence, metastasis and death. 2) Metaplastic and non-metaplastic carcinoma did not reveal any difference of the clinicopathologic findings except age distribution. 3) CEA and p53 were positive in preneoplastic and malignant lesions. The extent of staining was related to the degree of the atypia. From the above results, an early detection of gallbladder cancer is very important for the prognosis of the patients. Since preoperative diagnosis is difficult, thorough pathologic examination of routinely resected gallbladder is necessary for the early diagnosis. CEA and p53 immunohistochemical staining may be helpful in the differential diagnosis of non-neoplastic and neoplastic lesion of the gallbladder.
Subject(s)
Humans , Age Distribution , Diagnosis , Diagnosis, Differential , Early Diagnosis , Gallbladder Neoplasms , Gallbladder , Gallstones , Metaplasia , Mucous Membrane , Neoplasm Metastasis , Prognosis , RecurrenceABSTRACT
In order to evaluate the factor. which affect the five year survival rate and prognosti c factors of the early carcinoma of the esophagus and the gastric cardia treated with endoscopic Nd : YAG laser therapy , thirty-three patients were followed. Of the 33 patients , 32 ( 97% ) cases were cured , resul- ting in the disappearance of the cancer cells. They were followed up for 3 3- 78 months , with a mean of 55. 3 months. The survival rate of the 32 patients treated with endoscopic laser was computed with the Product limit estimate method ,and was compared with the natural history of early superficial carcinoma . of the esophagus and the gastric cardia. The five year survival rate was in 97% of the 32 patients treated with laser therapy ,in contrast to 67% (P