摘要
目的 :探讨硬化治疗在食管静脉曲张硬化治疗后食管、贲门癌发生中的作用。方法 :收集文献报道的 2 6例和我院 4例患者的临床资料分析食管静脉曲张硬化治疗后食管、贲门癌的发生状况 ,发生部位及其与注射部位 ,注射药物种类、剂量关系 ,治疗结束至发现肿瘤的时间。结果 :(1)肿瘤发生部位分散于食管中上 1/ 3、中 1/ 3、中下 1/ 3、下 1/ 3和贲门区与硬化治疗注射部位并非完全一致 ,(2 )肿瘤发生与硬化剂种类无明确关系 ,常用的各种硬化剂均有食管或贲门癌的病例发现 ,(3)发生肿瘤的病例 ,除 1例外硬化剂总用量均大于或等于 30ml,(4 )硬化治疗结束平均 19 4个月 (4～ 77个月 )发现肿瘤。结论 :硬化治疗在食管静脉曲张硬化治疗后食管、贲门癌的发生中起某种促进作用 ,这一作用可能是通过硬化剂对局部粘膜的化学性致炎作用而达成的 。
Objective:The aim of this study was to investigate whether endoscopic variceal sclerotherapy(EVS) is causally associated with esophageal or cardia carcinogenesis.Methods:Collecting total 29 cases of esophageal carcinoma and one case of cardia carcinoma after EVS have been reported,including the 4 cases in our hospital.And analyzing the relation between esophageal or cardia cancer and the position of the injection sclerosant,the kind of sclerosant,the dosage of sclerosant.Results:Among 30 cases men 28,women 2,age ranged from 35 to 68 years(mean 53.7±6.4),the latent period from 4 to 77 months.The sites of the esophageal or cardia carcinoma were the middle-upper third,the middle third,the middle-lower third,the lower third and the cardia.The position of the carcinoma was not consistent with the position of the injection sclerosant.Except for one case,the total dose of sclerosant was above or equal 30ml.There is no relation between the kind of sclerosant and esophageal or cardia carcinoma occurring after EVS.Conclusion:No evidence to prove the direct relation between the esophageal or cardia carcinoma and EVS,but EVS might accelerate to occur esophageal or cardia carcinoma by the inflammation of esophageal or cardia mucosa and poor movement after EVS.The importance of endoscopic follow-up after EVS is being detected not only variceal recurrence but also the occurrence of a neoplasm.
出处
《临床肿瘤学杂志》
CAS
2004年第6期571-573,577,共4页
Chinese Clinical Oncology
