Clinical impact of gastrointestinal endoscopy on the early detection of pharyngeal squamous cell carcinoma: A retrospective cohort study.
Clinical impact of gastrointestinal endoscopy on the early detection of pharyngeal squamous cell carcinoma: A retrospective cohort study.
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DOI：
10.4253/wjge.v13.i10.491
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发表时间：
2021-10-16
影响因子：
2
通讯作者：
Tanaka Y
中科院分区：
文献类型：
--
作者：
Miyamoto H;Naoe H;Morinaga J;Sakisaka K;Tayama S;Matsuno K;Gushima R;Tateyama M;Shono T;Imuta M;Miyamaru S;Murakami D;Orita Y;Tanaka Y
近年来，随着图像增强胃肠内窥镜的日益普及，胃肠病学家为咽部鳞状细胞癌（SCC）的早期发现做出了贡献。目的探讨消化道内镜检查咽部鳞状细胞癌的临床特点。这是一项回顾性队列研究，在日本一所大学医院的单中心进行。我们回顾性评估了2011年至2018年期间在我院接受检查的522例连续口咽或下咽SCC患者的临床记录。将病变分为两组：GE组（通过胃肠道内窥镜检查）和非GE组（通过胃肠道内窥镜以外的方法检查）。比较两组患者的临床特点。使用Mann-Whitney U检验比较连续数据。采用Pearson χ2检验或Fisher精确检验分析分类数据并比较比例。Kaplan-Meier法用于估计累积患者生存率。在我们的研究组中，中位年龄为65岁，474例患者（90.8%）为男性。196例（37.5%）累及口咽部，326例（62.5%）累及下咽部。395例（75.7%）在诊断时有一些症状。145例（27.8%）病例有ESCC并发症或ESCC病史。164例（31.4%）患者通过消化道内镜检查发现并分类为GE组。GE组无症状、cTis-1和无淋巴结转移的比例均显著高于非GE组（61.6% vs 7.3%，P < 0.001; 32.9% vs 12.0%，P < 0.001; 69.5% vs 19.0%，P < 0.001）。非GE组仅0.6%的病变行内镜下咽喉手术或内镜下粘膜下剥离术，而GE组为21.3%（P < 0.001）。GE组的总生存期显著长于非GE组（P = 0.018）。GE组2年和4年生存率分别为82.5%和70.7%，非GE组分别为71.5%和59.0%。消化道内镜检查对咽部SCC的早期发现和改善预后具有重要意义。
In recent years, with the growing availability of image-enhanced gastrointestinal endoscopy, gastroenterologists have contributed to the early detection of pharyngeal squamous cell carcinomas (SCC). To clarify the clinical characteristics of pharyngeal SCCs detected by gastrointestinal endoscopy. This is a retrospective cohort study conducted in a single-center, a university hospital in Japan. We retrospectively assessed the clinical records of 522 consecutive patients with oropharyngeal or hypopharyngeal SCC who were examined in our hospital between 2011 and 2018. The lesions were classified into two groups: Group GE (detected by gastrointestinal endoscopy) and Group non-GE (detected by means other than gastrointestinal endoscopy). The clinical characteristics were compared between the two groups. Continuous data were compared using the Mann–Whitney U test. Pearson’s χ2 test or Fisher's exact test was used to analyze the categorical data and compare proportions. The Kaplan–Meier method was used to estimate the cumulative patient survival rates. In our study group, the median age was 65 years and 474 patients (90.8%) were male. One hundred and ninety-six cases (37.5%) involved the oropharynx and 326 cases (62.5%) involved the hypopharynx. Three hundred and ninety-five cases (75.7%) had some symptoms at the time of diagnosis. One hundred and forty-five (27.8%) cases had concurrent ESCC or a history of ESCC. One hundred and sixty-four (31.4%) cases were detected by gastrointestinal endoscopy and classified as Group GE. The proportions of asymptomatic cases, cTis-1 cases and cases with no lymph node metastasis were significantly higher in Group GE than Group non-GE (61.6% vs 7.3%, P < 0.001, 32.9% vs 12.0%, P < 0.001 and 69.5% vs 19.0%, P < 0.001). Endoscopic laryngo-pharyngeal surgery or endoscopic submucosal dissection were performed in only 0.6% of the lesions in Group non-GE but in 21.3% of the lesions in Group GE (P < 0.001). Overall survival was significantly longer in Group GE than in Group non-GE (P = 0.018). The 2-year and 4-year survival rates were 82.5% and 70.7% in Group GE, and 71.5% and 59.0% in Group non-GE, respectively. Gastrointestinal endoscopy plays an important role in the early detection and improving the prognosis of pharyngeal SCCs.
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DOI：
10.1002/hed.23106
发表时间：
2013-09-01
影响因子：
2.9
作者：
Hanaoka, Noboru;Ishihara, Ryu;Tomita, Yasuhiko
通讯作者：
Tomita, Yasuhiko
DOI：
10.1111/j.1440-1746.2009.05993.x
发表时间：
2010-02-01
影响因子：
4.1
作者：
Nonaka, Satoru;Saito, Yutaka;Saito, Daizo
通讯作者：
Saito, Daizo
影响因子：
9.3
作者：
Iizuka, T.;Kikuchi, D.;Yahagi, N.
通讯作者：
Yahagi, N.
影响因子：
3.4
作者：
Eckel, HE;Staar, S;Jungehuelsing, M
通讯作者：
Jungehuelsing, M
影响因子：
4.3
作者：
Morimoto H;Yano T;Yoda Y;Oono Y;Ikematsu H;Hayashi R;Ohtsu A;Kaneko K
通讯作者：
Kaneko K