食管早癌ESD术后疗效评估及血清指标水平变化

Evaluation of the Efficacy and Changes of Se-rum Markers after ESD for Early Esophageal Cancer

摘要: 目的：观察食管早癌内镜黏膜下剥离术(ESD)术后疗效，并对比分析血清指标水平差异。方法：回顾性分析2017年1月至2021年10月在青岛市市立医院消化内镜中心行ESD治疗的100例食管早癌患者，评估患者治疗效果。并选取同期100例食管良性病变及健康查体患者，对比CA199、CA125、癌胚抗原(CEA)、鳞状细胞癌抗原(SCC)、中性粒细胞–淋巴细胞比率(NLR)血清指标水平变化。结果：100例行ESD治疗的食管早癌患者平均住院时间为(8.65 ± 1.65)天，平均手术时间为(57.28 ± 15.40)天，有效切除率(89/100)%、无效切除率(11/100)%，术后出血13例，食管狭窄2例，食管穿孔0例。食管早癌组患者术前血清CA199、CA125、CEA、SCC、NLR水平明显高于食管良性病变组、健康组，而食管早癌组患者术后3个月的血清CA199、CA125、CEA、SCC、NLR水平明显低于术后1个月，通过随访检测血清指标，食管早癌无效切除患者ESD术后6个月的血清CA125、CEA、SCC、NLR水平明显高于有效切除组，差异均有统计学意义(P < 0.05)。结论：ESD是治疗食管早癌的有效方法，食管早癌术后CA125、CEA、SCC、NLR水平明显降低，其水平变化与疗效相关，临床可应用于食管早癌的术前评估及疗效预测。

Abstract: Objective: To observe the effect of endoscopic submucosal dissection (ESD) for early esophageal cancer, and compare the difference of serum markers. Methods: Retrospective analysis was made on 100 patients with early esophageal cancer who received ESD treatment in the Digestive Endos-copy Center of Qingdao Municipal Hospital from January 2017 to October 2021, and the treatment effect was evaluated. In the same period, 100 patients with benign esophageal diseases and healthy people were selected to compare the changes of serum CA199, CA125, carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) and neutrophil lymphocyte ratio (NLR). Results: The average hospitalization time of 100 patients with early esophageal cancer treated with ESD was (8.65 ± 1.65) days, the average operation time was (57.28 ± 15.40) days, the effective resection rate was (89/100)%, the ineffective resection rate was (11/100)%, 13 patients suffered from postoper-ative bleeding, 2 patients suffered from esophageal stenosis, and 0 patients suffered from esopha-geal perforation. The levels of serum CA199, CA125, CEA, SCC, NLR in patients with early esophageal cancer before operation were significantly higher than those in patients with benign esophageal le-sions and healthy people, while the levels of serum CA199, CA125, CEA, SCC, NLR in patients with early esophageal cancer 3 months after operation were significantly lower than those in patients with early esophageal cancer 1 month after operation. Through follow-up and detection of serum indicators, the levels of serum CA125, CEA, SCC, NLR in patients with early esophageal cancer who failed to resect ESD 6 months after operation were significantly higher than those in patients with effective resection, The difference was statistically significant (P < 0.05). Conclusion: ESD is an effec-tive method for the treatment of early esophageal cancer. The levels of CA125, CEA, SCC and NLR decreased significantly after the operation of early esophageal cancer, and their changes are related to the curative effect. It can be used in the preoperative evaluation and prognosis of early esopha-geal cancer.