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| 1 | 消化道早癌及癌前病变内镜下切除与外科手术切除的效价比对比研究显示文摘目的对比研究内镜黏膜下剥离术(ESD)与传统外科手术治疗消化道早癌或癌前病变的效价比。方法选择2006年11月至2012年9月确诊的866位消化道早癌或癌前病变的住院患者,对其病历资料进行回顾性分析,根据治疗方法不同分为ESD组及传统外科手术组。记录和对比分析两组患者的基本信息、卫生经济学资料以及治疗情况。结果ESD组共607例患者,外科组共259例患者;两组病变的完全切除率相当(93.1%比93.0%,P〉0.05);ESD组和外科组的平均住院天数、住院费用分别为13.01d比18.88d(P〈0.05),22932.17元比57993.88元(P〈0.05);ESD组中共有22例(1.98%)患者出现术中及术后出血,17例(2.80%)患者出现穿孔;传统外科手术组中,共有8例(3.01%)出血、3例(1.16%)穿孔。两组出血及穿孔率差异无统计学意义。结论ESD术及传统外科手术均为治疗消化道早癌或癌前病变的有效手段,与传统外科手术治疗相比,ESD术在平均住院日、住院费用方面具有明显优势。 | 孙曦 张修礼 卢忠生 黄启阳 李延青 杨云生 | 2013 | 中华消化内镜杂志2013，30，1： | 36 |
| 2 | Unveiling lymph node metastasis in early gastric cancer显示文摘With respect to gastric cancer treatment,improvements in endoscopic techniques and novel therapeutic modalities[such as endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)]have been developed.Currently,EMR/ESD procedures are widely accepted treatment modalities for early gastric cancer(EGC).These procedures are most widely accepted in Asia,including in Korea and Japan.In the present era of endoscopic resection,accurate prediction of lymph node(LN)metastasis is a critical component of selecting suitable patients for EMR/ESD.Generally,indications for EMR/ESD are based on large Japanese datasets,which indicate that there is almost no risk of LN metastasis in the subgroup of EGC cases.However,there is some controversy among investigators regarding the validity of these criteria.Further,there are currently no accurate methods to predict LN metastasis in gastric cancer(for example,radiologic methods or methods based on molecular biomarkers).We recommend the use of a 2-step method for the management of early gastric cancer using endoscopic resection.The first step is the selection of suitable patients for endoscopic resection,based on endoscopic and histopathologic findings.After endoscopic resection,additional surgical intervention could be determined on the basis of a comprehensive review of the endoscopic mucosal resection/endoscopic submucosal dissection specimen,including lymphovascular tumor emboli,tumor size,histologic type,and depth of invasion.However,evaluation of clinical application data is essential for validating this recommendation.Moreover,gastroenterologists,surgeons,and pathologists should closely collaborate and communicate during these decisionmaking processes. | Nari Shin Tae-Yong Jeon Gwang Ha Kim Do Youn Park | 2014 | World Journal of Gastroenterology2014，20，18： | 10 |
| 3 | Endoscopic submucosal dissection for undifferentiated-type early gastric cancer: Do we have enough data to support this?显示文摘Although endoscopic submucosal dissection(ESD)is now accepted for treatment of early gastric cancers(EGC)with negligible risk of lymph node(LN)metastasis,ESD for intramucosal undifferentiated type EGC without ulceration and with diameter≤2 cm is regarded as an investigational treatment according to the Japanese gastric cancer treatment guidelines.This consideration was largely based on the analysis of surgically resected EGCs that contained undifferentiated type EGCs;however,results from several institutes showed some discrepancies in sample size and incidence of LN metastasis.Recently,some reports about the safety and efficacy of ESD for undifferentiated type EGC meeting the expanded criteria have been published.Nonetheless,only limited data are available regarding long-term outcomes of ESD for EGC with undifferentiated histology so far.At the same time,endoscopists cannot ignore the patients’desire to guarantee quality of life after the relatively non-invasive endoscopic treatment when compared to conventional surgery.To satisfy the needs of patients and provide solid evidence to support ESD for undifferentiated EGC,we need more delicate tools to predict undetected LN metastasis and more data that can reveal predictive factors for LN metastasis. | Choong Nam Shim Sang Kil Lee | 2014 | World Journal of Gastroenterology2014，20，14： | 10 |
| 4 | CD31联合D2-40检测在同时性结直肠癌腹膜转移中的研究显示文摘目的探讨CD31和D2-40在同时性结直肠癌腹膜转移患者中的表达情况及二者的相关性。方法采用免疫组织化学Max Vision法检测59例(其中伴腹膜转移者19例,不伴腹膜转移者40例)结直肠癌组织中CD31和D2-40蛋白表达情况。结果 (1)伴或不伴腹膜转移结直肠癌组织中CD31和D2-40蛋白表达阳性率均明显高于正常结肠组织(P<0.05),但二者在伴或不伴腹膜转移结直肠癌组织间比较的差异均无统计学意义(P>0.05)。(2)CD31微血管密度和D2-40微淋巴管密度在伴腹膜转移结直肠癌组织中均明显高于正常结肠组织(P<0.05)和不伴腹膜转移结直肠癌组织(P<0.05)。(3)CD31微血管密度和D2-40微淋巴管密度与不伴腹膜转移结直肠癌患者的所有临床病理特征均无关(P>0.05);但二者在伴腹膜转移的中低分化腺癌及黏液和印戒细胞癌中均明显高于其他类型(P<0.05),而与其性别、年龄及肿瘤直径均无关(P>0.05)。(4)在伴或不伴腹膜转移结直肠癌组织中CD31微血管密度和D2-40微淋巴管密度呈正相关(r=0.342,P=0.012;r=0.119,P=0.008)。结论在结直肠癌伴腹膜转移组织中的CD31微血管密度和D2-40微淋巴管密度均高于不伴腹膜转移者,且二者呈正相关,结果提示其与腹膜转移有一定的关系,并且可能存在某些共同调控的方式协同参与结直肠癌腹膜转移的发生。 | 朱信强 管文贤 | 2017 | 中国普外基础与临床杂志2017，24，12： | 2 |
| 5 | 内镜下穿孔修补术治疗肝硬化合并消化道穿孔患者疗效观察显示文摘目的探讨内镜下穿孔修补术治疗肝硬化合并消化道穿孔患者的疗效。方法将78例肝硬化合并消化道穿孔患者随机分为治疗组39例和对照组39例。给予治疗组内镜下穿孔修补术治疗,给予对照组传统的手术切除治疗。结果所有患者都顺利完成手术;治疗组手术时间、术中出血量、术后下床活动时间和术后住院时间分别为(128.34±15.33)min、(287.38±100.87)ml、(2.00±2.75)d和(6.25±2.95)d,均显著短于或少于对照组[分别为(123.87±15.77)min、(444.39±124.88)ml、(4.50±3.00)d和(9.85±4.66)d,P<0.05];治疗组术后肺部感染、切口感染、肠梗塞、腹腔感染等并发率显著低于对照组(P<0.05);治疗组生存时间为(47.44±6.44)个月,1 a生存率为97.4%,而对照组分别为(34.98±5.29)个月和82.1%(P<0.05)。结论内镜下穿孔修补术用于肝硬化合并消化道穿孔患者具有微创,术后并发症少等特点,从而可改善远期生存情况。 | 张振 周文波 | 2015 | 实用肝脏病杂志2015，18，6： | 0 |
| 6 | D2-40在结直肠癌淋巴道转移中的研究进展显示文摘结直肠癌是临床最常见的恶性肿瘤之一,在全球范围内,结直肠癌的发病率处于恶性肿瘤的第3位,而在欧洲发达国家,结直肠癌的发病率处于第2位。据统计,美国2011~2012年结直肠癌新发病数和死亡数均居美国癌症发病数和死亡数的第3位。在我国,随着居民生活水平的不断提高、饮食习惯的改变,结直肠癌的发病率呈逐年上升趋势。 | 邓洪 徐亮 | 2015 | 现代医药卫生2015，31，6： | 0 |
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