Clinical impact of surveillance for head and neck cancer in patients with esophageal squamous cell carcinoma.
Clinical impact of surveillance for head and neck cancer in patients with esophageal squamous cell carcinoma.
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DOI：
10.3748/wjg.v23.i6.1051
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发表时间：
2017-02-14
影响因子：
4.3
通讯作者：
Kaneko K
中科院分区：
文献类型：
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作者：
Morimoto H;Yano T;Yoda Y;Oono Y;Ikematsu H;Hayashi R;Ohtsu A;Kaneko K
目的评价窄带成像(NBI)监测头颈部(HN)区对食管鳞癌(ESCC)的临床意义。自2006年以来，我们引入了对所有ESCC患者治疗前和每次随访时使用NBI对HN地区进行监测。将新诊断的I~III期食管鳞癌患者分为两组：A组(1992~2000年间无HN地区监测)和B组(2006~2008年间HN地区NBI监测)。比较两组患者头颈浅表性鳞状细胞癌(HNSCC)的发现率及异时性晚期HNSCC的严重事件。共561例患者(A组：254例，B组：307例)入选。同期浅表性鼻咽癌A组1例(0.3%)，B组12例(3.9%)(P=0.008)。随访期异时性鼻咽癌A组10例(3.9%)，B组30例(9.8%)(P=0.008)。B组异时性病变均为早期病变，26例行局部切除，而A组10例中有6例(60%)丧失喉功能，死于异时性HNSCC。NBI内窥镜对HN区的监测可提高ESCC患者早期HNSCC的发现率，减少与晚期异时性HNSCC相关的严重事件。
To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC). Since 2006, we introduced the surveillance for HN region using NBI for all patients with ESCC before treatment, and each follow-up. The patients with newly diagnosed stage I to III ESCC were enrolled and classified into two groups as follows: Group A (no surveillance for HN region); between 1992 and 2000), and Group B (surveillance for HN region with NBI; between 2006 and 2008). We comparatively evaluated the detection rate of superficial head and neck squamous cell carcinoma (HNSCC), and the serious events due to metachronous advanced HNSCC during the follow-up. A total 561 patients (group A: 254, group B: 307) were enrolled. Synchronous superficial HNSCC was detected in 1 patient (0.3%) in group A, and in 12 (3.9%) in group B (P = 0.008). During the follow up period, metachronous HNSCC were detected in 10 patients (3.9%) in group A and in 30 patients (9.8%) in group B (P = 0.008). All metachronous lesions in group B were early stage, and 26 patients underwent local resection, however, 6 of 10 patients (60%) in group A lost their laryngeal function and died with metachronous HNSCC. Surveillance for the HN region by using NBI endoscopy increase the detection rate of early HNSCC in patients with ESCC, and led to decrease serious events related to advanced metachronous HNSCC.