[Application endoscopic mucosal resection to therapy early gastrointestinal cancer and precancerous lesion]

Abstract

Objective: To explore the clinical value of endoscopic mucosal resection (EMR) on early gastrointestinal cancer and precancerous lesion.

Methods: The EMR data of 42 lesions from 28 patients, collected from Apr. 2001 to Dec. 2005, were retrospectively analyzed. All the lesions were confirmed histologically before and after operation.

Results: Forty-two lesions were removed by the EMR from 28 patients. Lesion types observed under endoscopy were as follows: type I 9 lesions (type Isp 2 lesions, type Is 7 lesions), type II 33 lesions (type IIa 23 lesions, type IIa + IIc 4 lesions, type IIb 6 lesions). Thirty-eight EMRs were performed by using snare resection techniques and 4 EMRs by using suction cap-assisted techniques. The size of lesions changed from 0.6 cm x 0.6 cm to 3.0 cm x 3.5 cm. Complete resections were achieved in 36 of 40, among them, 2 lesions were divided into 2 pieces and 1 lesion was divided into 3 pieces. Post-EMR histopathologic evaluation revealed the following

Results: carcinoma in 4 lesions, high-grade dysplasia (HGD) in 11 lesions, middle-grade dysplasia (MGD) in 17 lesions, adenoma in 6 lesions, non-adenoma in 2 lesions. The pathology match rate between local biopsy and EMR was 60.0%. The detection rates of cancer, HGD and MGD by EMR were higher than that by routine biopsy. No serious complications were seen in this study.

Conclusion: Endoscopic mucosal resection has significant impact on the endoscopic intervention treatment of early cancer and precancerous lesion in digestive tract.