Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2025; 17(4): 103700
Published online Apr 27, 2025. doi: 10.4240/wjgs.v17.i4.103700
Endoscopic submucosal dissection for esophageal precancerous lesions and early esophageal carcinoma: Analysis of efficacy and serum tumor markers
Xiao-Chen Yuan, Ping Jia, Tian Tian, Jun Zhu, Xiao-Yan Zhang
Xiao-Chen Yuan, Ping Jia, Jun Zhu, Xiao-Yan Zhang, Department of Gastroenterology, The Affiliated Taizhou Second People’s Hospital of Yangzhou University, Taizhou 225300, Jiangsu Province, China
Tian Tian, Department of Laboratory Medicine, The Affiliated Taizhou Second People’s Hospital of Yangzhou University, Taizhou 225300, Jiangsu Province, China
Author contributions: Yuan XC designed the research and wrote the first manuscript; Yuan XC, Jia P, Tian T, Zhu J and Zhang XY contributed to conceiving the research and analyzing data; Yuan XC conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethic Committee of The Affiliated Taizhou Second People’s Hospital of Yangzhou University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: Dr. Yuan has nothing to disclose.
Data sharing statement: sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Chen Yuan, Department of Gastroenterology, The Affiliated Taizhou Second People’s Hospital of Yangzhou University, No. 27 Jiankang Road, Jiangyan District, Taizhou 225300, Jiangsu Province, China. 15261020588@163.com
Received: January 8, 2025
Revised: February 25, 2025
Accepted: March 5, 2025
Published online: April 27, 2025
Processing time: 79 Days and 23.3 Hours
Abstract
BACKGROUND

Tumor progression in patients with esophageal precancerous lesions (EPLs) or early esophageal carcinoma (EEC) is typically confined in both extent and location. Prompt and effective intervention significantly improves treatment outcomes and prognosis for these individuals.

AIM

To determine the effect of endoscopic submucosal dissection (ESD) on efficacy, serum tumor markers (STMs), and 6-month postoperative recurrence rate in patients with either EPL or EEC.

METHODS

This study initially enrolled 120 patients with EPL or EEC, who were admitted from April 2021 to April 2024. Participants were divided into the control group (60 cases), which underwent thoracotomy, and the research group (60 cases) which received ESD treatment. The comparative analysis involved information regarding the efficacy (dissection area and resection rate per unit time), complications (delayed bleeding, wound infection, esophageal reflux, and postoperative esophageal stenosis), surgery-related parameters (bleeding volume, operation duration, and hospital length of stay), STMs [carcinoembryonic antigen (CEA), carbohydrate antigen 724 (CA724), and tumor-specific growth factor (TSGF)], and the 6-month postoperative recurrence rate of the two groups.

RESULTS

Data indicated statistically higher dissection area and resection rate per unit of time in the research group than in the control group. Meanwhile, the research group demonstrated a notably lower overall incidence rate of complications, bleeding volume, operation duration, and hospital length of stay. Further, the CEA, CA724, and TSGF were markedly reduced in the research group after treatment, which were statistically lower compared to the baseline and those of the control group. Finally, during the follow-up, a comparable 6-month postoperative recurrence rate was determined in the two groups.

CONCLUSION

ESD is clinically effective and safe for EPL and EEC and can significantly restore abnormally increased levels of STMs.

Keywords: Endoscopic submucosal dissection; Esophageal precancerous lesions; Early esophageal carcinoma; Therapeutic efficacy; Serum tumor markers

Core Tip: Studies on the efficacy of endoscopic submucosal dissection (ESD) in treating esophageal precancerous lesions (EPLs) or early esophageal carcinoma (EEC), as well as its effects on serum tumor markers (STMs) and the 6-month postoperative recurrence rate, remains limited. This study included 120 patients with EPL or EEC and compared the clinical outcomes of ESD with thoracotomy. The results indicate that ESD provides significant clinical advantages for these patients, including larger dissection area, higher resection rate per unit time, reduced risk of complications, less intraoperative bleeding, shorter operative duration, and accelerated recovery. Moreover, ESD effectively suppresses abnormal STM levels, such as carcinoembryonic antigen, carbohydrate antigen 724, and tumor-specific growth factor. These results provide comprehensive and robust clinical evidence to support the use of ESD in EPL and EEC management.