背景:涉及肛管的表面浸润性鳞状细胞癌(SISCC)和高度鳞状上皮内病变(HSIL)很少见,他们的手术管理涉及局部切除。内镜粘膜下剥离术(ESD)最近已成为一种有希望的治疗方法。本研究旨在评估ESD在肛管SISCC和HSIL中的可行性和安全性。
方法:纳入2018年11月至2023年5月期间在肛管中诊断为SISCC或HSIL且接受ESD的所有患者。患者年龄,性别,病理学,人类免疫缺陷病毒(HIV)状态,人乳头瘤病毒(HPV)状态,T级,集团汇率,分析R0切除率。
结果:10名患者,包括两个男人和八个女人,纳入的中位年龄为61岁(51~68岁).所有患者均为HIV阴性,但5例(50%)HPV阳性.病理检查显示2例患者的肿瘤分期为T2,1例为SISCC的T0,七个是HSIL的Tis。标本中位数和肿瘤大小分别为24(6-65)mm和18(6-55)mm,分别。整体切除率和R0切除率分别为100%和80%,分别。无严重并发症发生,随访时无复发(中位随访期,9(1-35)个月)。
结论:ESD是一种可靠的微创手术,可以为特定人群提供更多的个性化治疗选择。由于我们受到观察期长度的限制,涉及肛管的SISCC和HSIL的ESD长期表现需要进一步研究.
BACKGROUND: Superficially invasive squamous cell carcinoma (SISCC) and high-grade squamous intraepithelial lesions (HSIL) involving the anal canal are rare, and their surgical management involves local excision. Endoscopic submucosal dissection (ESD) has recently emerged as a promising treatment. This study aimed to evaluate the feasibility and safety of ESD for SISCC and HSIL in the anal canal.
METHODS: All patients diagnosed with SISCC or HSIL in the anal canal who underwent ESD between November 2018 and May 2023 were included. Patient age, sex, pathology, human immunodeficiency virus (HIV) status, human papillomavirus (HPV) status, T stage, en bloc rate, and R0 resection rate were analyzed.
RESULTS: Ten patients, including two men and eight women, with a median age of 61 (51-68) years were enrolled. All patients were HIV-negative, but five (50%) were HPV-positive. Pathological examination showed tumor stage of two patients as T2, one as T0 of SISCC, and seven as Tis of HSIL. The median specimen and tumor sizes were 24 (6-65) mm and 18 (6-55) mm, respectively. The en bloc and R0 resection rates were 100% and 80%, respectively. No severe complications occurred and no recurrence was observed at the follow-up (median follow-up period, 9 (1-35) months).
CONCLUSIONS: ESD is a reliable and minimally invasive procedure that enables more individualized treatment options for specific groups. As we were limited by the length of the observation period, the long-term performance of ESD for SISCC and HSIL involving the anal canal requires further investigation.