[Surgical treatment of malignant esophageal tumors in PUMC Hospital].
OBJECTIVE: To study how to prolong the postoperative survival time of the patients with malignant esophageal tumors. METHODS: The clinical data of 1,098 patients with malignant esophageal tumors from 1961 to 1992 were retrospectively analyzed. The deletion of fragile histamine triplet(FHIT) gene(a tumor suppressor gene) in 30 fresh esophageal samples obtained in 1996 was detected with PCR and RT-PCR. RESULTS: The resectability was raised gradually and the operative morbidity and mortality decreased year-by-year, but there was no significant improvement on the postoperative 5-year survival rate. Delayed diagnosis and ir-radical resection influenced the long term survival. The deletion of cDNA of FHIT gene was 64.2% in esophageal cancer and 20% in the resected margin of the cancer. CONCLUSIONS: High atypical hyperplasia in esophageal epithelium and deletion of FHIT gene in esophageal cancer and its resected margin are pathological and molecular markers for early diagnosis of esophageal cancer respectively, and the latter may be one of the molecular markers for the resection. Early diagnosis and treatment, radical resection, and postoperative nutritional support are essential for the improvement of the postoperative survival time of the patients.
Guo, H; Li, Z; Zhang, Z; Sun, C; Xu, L; Li, W; Wang, S; Wu, M
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