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目的：研究内镜Ｎｄ：ＹＡＧ激光治疗食管和贲门早期表浅癌的远期疗效和ＤＮＡ及ｐ５３表达与预后的关系。方法：对内镜激光治疗癌细胞消失的３２例食管和贲门早期表浅癌病人进行３３～７８个月（平均５５．３个月）的随访。并与１１７例早期食管癌和贲门癌的自然病程对比分析。应用ＰｒｏｄｕｃｔＬｉｍｉｔＥｓｔｉｍａｔｅ方法计算其存活率。应用免疫组化染色法检测ｐ５３表达。应用分光光度计测定癌细胞ＤＮＡ含量。结果：内镜激光治疗５年存活率为９７％，自然病程５年存活率为６７％（Ｐ＜０．０１）。ｐ５３阳性表达和ＤＮＡ非整倍体型病人的复发率分别为７６．９％和６４．３％。结论：内镜Ｎｄ：ＹＡＧ激光是治疗食管和贲门早期表浅癌的有效方法。抗癌基因ｐ５３和ＤＮＡ倍体数与病人的预后有关。
Objective: To study the long-term efficacy of endoscopic Nd:YAG laser in the treatment of early superficial carcinoma of the esophagus and cardia and the relationship between DNA and p53 expression and prognosis. METHODS: Thirty-two cases of early esophageal and cardiac cancer with distal endoscopic laser treatment of cancer cells were followed for 33 to 78 months (average 55.3 months). And compared with the natural course of 117 cases of early esophageal and cardiac cancer. The ProductLimitEstimate method was used to calculate its survival rate. The expression of p53 was detected by immunohistochemical staining. A spectrophotometer was used to determine the DNA content of cancer cells. Results: The 5-year survival rate of endoscopic laser treatment was 97%, and the 5-year survival rate of natural course was 67% (P<0.01). The recurrence rates of p53 positive and DNA aneuploid patients were 76.9% and 64.3%, respectively. Conclusion: Endoscopic Nd:YAG laser is an effective method for the treatment of early superficial carcinoma of the esophagus and cardia. The number of anti-oncogene p53 and DNA ploidy is related to the patient’s prognosis.