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Clinical features of pharyngeal intraepithelial neoplasias and outcomes of treatment by endoscopic submucosal dissection.

Abstract：

BACKGROUND:Endoscopic detection of superficial squamous epithelial lesions of the pharynx has increased. OBJECTIVE:To clarify the association between macroscopic and histologic characteristics of intraepithelial pharyngeal neoplasias, and to evaluate the effectiveness of endoscopic submucosal dissection (ESD) for their treatment. DESIGN:Retrospective analysis of the features of high-grade dysplasia or carcinoma in situ (HGD/CIS) versus low-grade dysplasia (LGD) and of ESD-based outcomes. SETTING:Endoscopy department at a university hospital. PATIENTS:Fifty-one patients with 66 lesions treated by ESD from November 2007 to March 2011. RESULTS:Primary hypopharyngeal lesions were significantly more frequent in HGD/CIS than in LGD (54.1% vs 20.7%, P = .011), and oropharyngeal lesions were significantly less frequent in HGD/CIS (45.9% vs 79.3%, P = .011). HGD/CIS lesions were significantly larger than LGD lesions (median 8 mm vs 4 mm, P < .01). Morphologically, type 0-IIa was significantly more frequent in HGD/CIS lesions than in LGD lesions (37.8% vs 3.4%, P < .001), and type 0-IIb was significantly less frequent in HGD/CIS lesions (59.5% vs 96.6%, P < .001). The type IV intraepithelial papillary capillary loop pattern was significantly less frequent in HGD/CIS lesions than in LGD lesions (27.0% vs 55.2%, P = .025), and type V-2 was significantly more frequent in HGD/CIS lesions (18.9% vs 0%, P = .015). The en bloc resection rate was 97%. No serious complications occurred. There were no recurrent or metachronous tumors in the 41 patients followed for more than 1 year (median follow-up 27 months). LIMITATIONS:Retrospective design and single-center study. CONCLUSIONS:HGD/CIS and LGD differ in various clinical features. ESD appears to be an effective treatment for pharyngeal intraepithelial neoplasias.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Kuwabara T,Hiyama T,Oka S,Urabe Y,Tanaka S,Yoshihara M,Arihiro K,Shimamoto F,Chayama K

doi

10.1016/j.gie.2012.07.032

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

1095-103

issue

6

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(12)02543-6

journal_volume

76

pub_type

杂志文章

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