Abstract:

Objective To investigate the effect of neoadjuvant chemotherapy combined with total endo⁃ scopic Mckeown procedure on serum transforming growth factor⁃β1（TGF⁃β1），squamous cell carcinoma（SCC）⁃ associated antigen and long ⁃term curative effect in patients with middle and upper esophageal cancer. Methods The clinical data of 96 patients with middle and upper esophageal cancer in the hospital were retrospectively analyzed. According to the treatment method，they were divided into two groups. Patients in the study group were treated with neoadjuvant chemotherapy and subjected to total endoscopic Mckeown procedure，while patients in the control group were subjected to total endoscopic Mckeown procedure alone. The levels of TGF ⁃ β1 and SCC in the two groups were compared，and quality of life，recurrence，survival rate and the incidence of long⁃term complications in the two groups were analyzed. Results At 3 months after operation，serum TGF⁃β1 and SCC level in the two groups were significantly lower than those before operation（P < 0.05，respectively），and serum TGF⁃β1 and SCC level in the study group were significantly lower than those in the control group（P < 0.05，respectively）. Before operation，no significant difference in quality of life scores was observed between the two groups（P > 0.05），but patients in the study group had significantly higher quality of life scores than those in the control group at 6 and 9 months after operation（P < 0.05）. The recurrence rate and recurrence time in the study group during the follow⁃up period were significantly lower and shorter than those in the control group（P < 0.05，respectively）. One year after operation，there was no significant difference in the survival rate between the two groups（P > 0.05），but the sur⁃ vival rate in the study group was significantly higher than that in the control group at 3 and 5 years after operation （P < 0.05）There was no significant difference in the incidence of long⁃term complications between the two groups（P > 0.05）. Conclusion Neoadjuvant chemotherapy combined with total endoscopic Mckeown procedure could effectively lower serum TGF⁃β1 and SCC levels in patients with middle and lower esophageal cancer.

Key words:

neoadjuvant chemotherapy, total endoscopic Mckeown procedure, esophageal cancer, TGF?β1, SCC, long?term curative effect