BACKGROUND:Metabolic (dysfunction)-associated fatty liver disease is the most common liver disease related to various metabolic disorders. Colorectal adenomas are related to metabolic dysregulation. Despite the proposed association between non-alcoholic fatty liver disease and colorectal adenomas, the influence of metabolic-associated fatty liver disease on colorectal adenomas has yet to be investigated. Our study investigates the relationship between metabolic-associated fatty liver disease and colorectal adenomas and evaluates the predictive value of fatty liver index for colorectal adenomas. METHODS:A retrospective cross-sectional study was conducted on 650 inpatients at Qinghai Provincial People's Hospital. All participants underwent colonoscopy, abdominal ultrasound or CT, relevant laboratory tests, and physical examinations to ascertain baseline characteristics and overall health status. Multivariate logistic regression analysis examined the relationship between metabolic-associated fatty liver disease and colorectal adenomas. Lastly, the ability to identify, accuracy, and clinical applicability of predicting colorectal adenomas through fatty liver index were assessed using receiver operating characteristic curve area under the curve, calibration curve, and decision curve analysis. RESULT:In both the colorectal adenomas and control groups, the prevalence of metabolic-associated fatty liver disease was 62.1 % and 35.7 %, respectively. Multivariate analysis indicates that metabolic-associated fatty liver disease was independently correlated with an increased risk of colorectal adenomas (OR, 1.565; 95 % CI, 1.057-2.319; P < 0.05). Further analysis revealed that the risk of colorectal adenomas increased with an increasing quantity of metabolic components in metabolic-associated fatty liver disease (Ptrend < 0.001). The area under the curve of the fatty liver index predictive model was 0.838, with a 95 % CI of 0.807-0.869. The calibration curve indicated excellent agreement, and the decision curve analysis revealed a higher net benefit. CONCLUSION:The risk of colorectal adenomas was associated with metabolic-associated fatty liver disease, and the risk of developing colorectal adenomas increased with the presence of more metabolic-associated fatty liver disease metabolic components. Furthermore, fatty liver index served as a predictive indicator for screening colorectal adenomas.

目的:探讨长链非编码RNA核富集转录子 1(lncRNA NEAT1),对 miR-506-5p/丝切蛋白2(CFL2)轴的调控作用,及其对人胃癌细胞增殖、凋亡、侵袭等生物学行为的影响.方法:体外培养BGC-823 细胞,将lncRNA NEAT1 低表达载体(si-NEAT1)及miR-506-5p抑制物(miR-506-5p inhibi-tor)转染至BGC-823 细胞,分为 si-NC 组、si-NEAT1 组、inhibitor NC 组、miR-506-5p inhibitor 组、si-NEAT1+inhibitor NC组、si-NEAT1+miR-506-5p inhibitor 组.RT-qPCR 检测 lncRNA NEAT1 及 miR-506-5p表达以判定转染效率;CCK-8 法检测增殖;流式细胞测量术检测细胞凋亡;Transwell 小室法检测侵袭;Western blot检测CFL2、细胞周期素依赖激酶4(CDK4)蛋白表达.双荧光素酶报告基因实验验证lncRNA NEAT1、CFL2 与miR-506-5p的靶向关系;裸鼠荷瘤试验进一步验证 lncRNA NEAT1、miR-506-5p、CFL2 三者之间的靶向调控作用.结果:与 si-NC 组相比,si-NEAT1 组细胞增殖、侵袭能力、CFL2 表达降低,凋亡率、miR-506-5p表达升高(P<0.05).与inhibitor NC组相比,miR-506-5p inhibi-tor组细胞增殖、侵袭能力、CFL2 表达增加,凋亡率、miR-506-5p 表达降低(P<0.05).LncRNA NEAT1可靶向调节 miR-506-5p 表达,CFL2 是 miR-506-5p 的靶基因.敲低 miR-506-5p 可减弱 lncRNA NEAT1 低表达发挥的抗增殖、抗侵袭、促凋亡作用(P<0.05).miR-506-5p inhibitor 可减弱 lncRNA NEAT1 低表达发挥的抗移植瘤增长作用(P<0.05);过表达CFL2 可减弱miR-506-5p 过表达的抗移植瘤增长作用(P<0.05).结论:LncRNA NEAT1 可通过靶向调控miR-506-5p/CFL2 轴,来影响人胃癌细胞的增殖、侵袭、凋亡等生物学行为.

The number of patients with intestinal diseases is increasing year by year. With the continuous replacement of image enhanced endoscopy (IEE) technology, the brightness and quality of images have been significantly improved. By optimizing visualization methods, the detection rate of intestinal diseases is expected to increase. In 2012, Fuji Corporation of Japan officially launched the Blue Laser Endoscopy System LASEREO.Fuji Corporation′s innovative multi LED light source integration technology can achieve four different observation modes: white light imaging (WLI), blue laser imaging (BLI), bright blue imaging (BLI-bright), and linked color imaging (LCI). LCI mode can reconfigure colors by adding a red accent signal. By expanding the color near the "redness" of the mucosa, signal processing increases color contrast, making it a special light staining technique.Numerous studies have shown that LCI can significantly improve the detection rate of redness and discoloration lesions.The effectiveness of LCI has been unanimously recognized by endoscopic physicians both domestically and internationally.Based on the current literature reports on the role of LCI in intestinal diseases, the following summary is made on the research progress of LCI in this field.

Dyslipidemia may be related to the occurrence and development of colorectal tumors.Numerous studies have confirmed that dyslipidemia increases the risk of colorectal adenomas at present;however,the association of dyslipidemia with colorectal serrated lesions and colorectal cancer is still controversial,and there are few relevant reviews in China.This article comprehensively explores the correlation of dyslipidemia with colorectal serrated lesions and colorectal cancer,analyzes the possible causes of controversy,identifies the directions of subsequent researches,and discusses the role of dyslipidemia in the occurrence and progression of colorectal tumors.This article indicates that dyslipidemia is associated with colorectal serrated lesions and colorectal cancer.Dyslipidemia may be involved in the development of colorectal tumors through the interaction of multiple mechanisms such as insulin resistance,inflammatory factors,oxidative stress,high-fat diet and immunosuppression.The incidence of colorectal cancer is increasing yearly with a relatively slower natural course and more definite precancerous lesions.Therefore,the clarification of correlation between lipid indexes and colorectal tumors can facilitate early prevention and targeted screening of colorectal tumors and provide a reference for formulating targeted prevention strategies for colorectal cancer.

目的 探讨靶向表皮生长因子受体(EGFR)的嵌合抗原受体T细胞(CAR-T)对胃癌SGC-7901 细胞杀伤作用.方法 构建靶向EGFR的CAR-T,通过流式细胞仪、乳酸脱氢酶实验检测CAR-T对SGC-7901 细胞的杀伤作用;通过酶联免疫吸附试验(ELISA)检测SGC-7901 和CAR-T共培养干扰素(IFN)-γ、白细胞介素(IL)-2 的浓度变化.结果 CAR-T对胃癌SGC-7901 细胞杀伤作用随着效靶比的增加、作用时间的延长而显著增强(P<0.05);ELISA 结果显示,CAR-T作用后分泌IFN-γ、IL-2 显著增加(P<0.05).结论 靶向EGFR的CAR-T细胞能通过增加IFN-γ、IL-2 的分泌,特异性杀伤胃癌SGC-7901细胞.

目的 探讨内镜黏膜下剥离术(ESD)治疗早期胃癌(EGC)的术后复发情况及相关危险因素.方法 回顾性分析2016年1月-2019年12月青海省人民医院消化内科实施ESD治疗且病理结果为EGC的258例患者的临床及随访资料,分析影响术后复发的相关因素.结果 258例患者术后均获得长期随访,随访期间14例复发,复发率为5.4％,平均复发时间为(10.6±4.3)个月.经单因素和多因素统计分析,病变浸润深度为SM2或以上(OR^=5.22,95％CI:1.257～21.648,P=0.023)、病变最大径≥4.0 cm(OR^=5.23,95％CI:1.331～20.568,P=0.018)是影响ESD术后复发的独立危险因素.结论 ESD治疗EGC临床疗效好,病变的浸润深度及大小是影响ESD术后复发的独立危险因素.

本文报道1例64岁女性胃体幽门腺腺瘤（PGA）患者，系罕见散发病例，且该患者无自身免疫性胃炎、无家族性腺瘤性息肉病史、未感染幽门螺杆菌及无萎缩性胃炎。PGA是一种罕见的胃肠道肿瘤。腺体呈现胃幽门腺分化，细胞呈立方或柱状，胞质嗜酸性至嗜两性，无黏蛋白帽。免疫组织化学染色细胞具有胃幽门腺分化的标志物，包括黏蛋白5Ac（MUC5Ac）和MUC6。患者于2018年1月19日在静脉麻醉下行内镜黏膜下剥离术（ESD）。最终病理诊断：胃PGA；肉眼分型：0~Ⅱa；病变范围：1.0 cm×0.5 cm；水平切缘及基底切缘净。PGA可以进行保守治疗，也可行ESD完全切除。

目的:探讨青海地区内镜下冷、热圈套器切除结直肠小息肉的安全性及有效性.方法:分析我院2018年1月-2021年3月诊断结直肠小息肉(直径5 mm～10 mm)患者361例,其中内镜下冷圈套器切除术(cold snare polypectomy,CSP)187例(CSP组)、内镜下热圈套器切除术(hot snare polypectomy,HSP)174 例(HSP 组).比较两组患者手术及住院情况、术后并发症发生情况、息肉特点.结果:两组患者性别、年龄、回肠末端插管成功率、波士顿评分、息肉部位、巴黎分型、病理类型、息肉完整切除率比较,差异均无统计学意义(P＞0.05);CSP组平均切除时间为(3.76±2.10)min短于HSP组的(5.29±2.04)min(P＜0.05);CSP 组平均住院天数为(4.71±1.62)d 短于 HSP 组的(6.10±1.88)d(P＜0.05);CSP组术后并发症总发生率为1.61％小于HSP组的9.19％(P＜0.05).结论:CSP与HSP均可有效的治疗结直肠小息肉,但CSP更简便、更快捷、更经济、更安全,值得临床推广应用.

目的:建立HPLC-ELSD法测定生化丸中4种糖含量的方法.方法:选用Prevail Carbohydrate ES 5u色谱柱(250 mm×4.6 mm,5 μm),用ELSD检测器采集信号,采用外标法进行定量;以乙腈-水溶液(77∶23)为流动相;等度洗脱;体积流量:1.0mUmin;柱温:25℃,漂移管温度:75℃.结果:生化丸中果糖、葡萄糖、蔗糖、麦芽糖分别在1.653～76.259、3.398～152.470、1.927～103.624、1.936～102.583 μg范围内线性关系良好;4种成分精密度、稳定性、重复性试验的RSD均小于2.0％(n=6);4种成分平均加样回收率≥95％,RSD均小于2.0％(n=6).结论:该方法选择性强,灵敏度高,可用于测定生化丸中蜂蜜果糖、葡萄糖、蔗糖、麦芽糖含量,为控制生化丸中蜂蜜质量提供依据.

食管癌(esophageal cancer,EC)是指原发于食管黏膜上皮的恶性肿瘤,主要为鳞状细胞癌和腺癌.尽管近几十年来北美和欧洲食管腺癌的发病率明显上升,但食管鳞状细胞癌尤其是在中国仍是EC的主要亚型[1];根据2018年的一份调查显示:EC新发病例处于36种主要癌症的第7位,约有57.2万,并且约有50万人因此死亡,死亡率位于第6位[2];我国是EC高发国家,其新发病例数的世界比重超过60％[3].并且EC早期无相应症状或仅有不典型的临床表现,常易被患者忽略,当临床症状明显时,病情大多已进展为中晚期,预后差,相对生存率仅为10％～15％[4].而病灶局限于黏膜层和(或)黏膜下浅层且不伴有淋巴结转移的早期EC经内镜下治疗后患者5年生存率可超过95％[5],因此EC的早期诊断、早期治疗对提高生存率起着至关重要的作用.

Objective:To explore the clinical significance of standardized screening for diagnosis and treatment of early gastric cancer in Qinghai Province.Methods:Opportunistic early gastric cancer screening was conducted in outpatients of Digestive Department, Physical Examination Center and inpatients of Qinghai Provincial People′s Hospital from January 2016 to December 2020, according to the optimal cut-off values of serum pepsinogen (PG)Ⅰ, PGⅠ/PGⅡ ratio (PGR) and serum gastrin 17 (G17) obtained from the previous screening study of gastric cancer and precancerous diseases in different areas of Qinghai Province. At the same time, the standardized early gastric cancer screening program was applied in 10 municipal (county-level) hospitals in Qinghai Province. The detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital and the above 10 hospitals in the past five years were analyzed respectively.Results:In the five years, the total detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital were 0.214% (407/190 178), 17.54% (407/2 321) and 81.82% (333/407), respectively. The above indices in 10 other hospitals were 0.085% (264/309 217), 12.94% (264/2 040) and 37.12% (98/264), respectively. The overall detection rate of early gastric cancer was higher than 0.024% reported previously.Conclusion:The standardized early gastric cancer screening program can not only improve the diagnosis rate of early gastric cancer in Qinghai Province, but also save medical resources. It is an economical, efficient and feasible program, suitable for the highin-cidence area of gastric cancer in Qinghai Province.

目的:分析1例肠穿孔患者碘克沙醇致过敏性休克病例资料,为临床合理用药提供参考及指导.方法:收集1例肠穿孔患者碘克沙醇致过敏性休克病例资料并进行分析,总结经验.结果:经积极治疗后患者饮食、睡眠、大小便正常,无发烧、寒战,腹胀、腹痛不适,好转后出院.结论:使用碘克沙醇前应详细询问药物过敏史,用药过程中和停药后均应注意观察,警惕过敏性休克的发生,以确保患者生命安全,此外,禁食水患者应适当给予维生素K治疗,防止凝血异常.

目的:分析1例肠穿孔患者CT检查中碘克沙醇致过敏性休克的病例资料,为临床合理用药提供参考及指导.方法:收集2019年9月7日我科收治的1例肠穿孔患者碘克沙醇致过敏性休克病例资料,进行分析及总结经验.结果:经积极治疗后患者凝血功能、饮食、睡眠、大小便恢复正常,无发烧、寒战,无腹胀、腹痛不适,好转出院.结论:使用碘克沙醇前应详细询问患者药物过敏史,用药过程中及停药后均应注意观察,警惕过敏性休克的发生,以确保患者生命安全.此外,禁饮食患者应适当给予维生素K治疗,防止凝血异常.

目的:检测高原地区ADP-核糖机化因子(ARF)在胃癌及癌旁组织中的表达,分析ARF与胃癌的临床病理关系及对预后的影响,旨在探讨ARF在胃癌组织中的表达及其临床意义.方法:选取原发性胃癌组织标本50例,其癌旁组织标本50例,免疫组化检测ARF在胃癌及癌旁组织中蛋白的表达;实时荧光定量PCR方法检测ARFmRNA在胃癌及癌旁组织中的表达.结果:与癌旁组织比较,胃癌组织中ARF蛋白及mRNA的表达均显著升高(P＜ 0.05),其中ARF在胃癌组织中的蛋白阳性表达率为72.0％,而癌旁组织中的蛋白阳性表达率为10.0％.ARF蛋白表达与胃癌患者的性别、年龄、部位、肿瘤大小及分化程度无明显相关(P＞0.05),与胃癌浸润深度、淋巴结转移及TNM分期有关(P＜0.05).结论:①胃癌组织中ARF高表达,说明ARF检测可能作为检测胃癌的生物学标志之一;②ARF蛋白表达与胃癌患者的性别、年龄、部位、肿瘤大小及分化程度无关,与胃癌浆膜有无浸润、淋巴结转移及TNM分期有关,其可能在胃癌发生、发展中起重要作用,有可能成为判断胃癌患者预后的标志之一.

目的 探讨长链非编码RNA FLVCR1-AS1(lncRNA FLVCR1-AS1)调控微小RNA-381-3p(miR-381-3p)表达影响结直肠癌(CRC)细胞增殖、凋亡的作用及机制.方法 取正常结肠上皮细胞FHC及CRC细胞SW480、DLD-1、HCT116,采用qRT-PCR法检测细胞中的FLVCR1-AS1与miR-381-3p.将FLVCR1-AS1表达最高的CRC细胞随机分为7组:NC组不处理,si-FLVCR1-AS1组、si-con组分别转染FLVCR1-AS1小干扰RNA及乱序无意义序列,miR-381-3p组、miR-con组分别转染miR-381-3p模拟物(mimics)及阴性对照mimic NC序列(miR-con),si-FLVCR1-AS1+anti-miR-381-3p组、si-FLVCR1-AS1+anti-miR-con组分别共转染si-FLVCR1-AS1与miR-381-3p特异性寡核苷酸抑制剂及其阴性对照;采用MTT法测算细胞存活率,流式细胞术测算细胞凋亡率,Western blotting法检测细胞周期蛋白D1(Cyclin D1)、活化的含半胱氨酸的天冬氨酸蛋白水解酶3(Cleaved-Caspase-3).先用Starbase对FLVCR1-AS1和miR-381-3p结合进行预测,再以双荧光素酶报告基因检测FLVCR1-AS1与miR-381-3p的相互作用.结果 与FHC比较,SW480、DLD-1、HCT116中FLVCR1-AS1表达水平均升高而miR-381-3p表达水平均降低(P均<0.05),其中SW480的FLVCR1-AS1表达最高.与NC组、si-con组、miR-con组比较,si-FLVCR1-AS1组、si-FLVCR1-AS1+anti-miR-con组细胞存活率降低、细胞凋亡率升高,细胞中Cyclin D1蛋白表达量降低、Cleaved-Caspase-3蛋白表达量升高(P均<0.05);miR-381-3p组细胞存活率降低、细胞凋亡率升高,细胞中Cyclin D1蛋白表达量降低、Cleaved-Caspase-3蛋白表达量升高(P均<0.05);NC组、si-con组、miR-con组两两比较,差异均无统计学意义;与si-FLVCR1-AS1+anti-miR-con组比较,si-FLVCR1-AS1+anti-miR-381-3p组细胞存活率升高、细胞凋亡率降低,细胞中Cyclin D1蛋白表达量升高、Cleaved-Caspase-3蛋白表达量低(P均<0.05).Starbase预测显示,FLVCR1-AS1与miR-381-3p存在靶向结合位点;双荧光素酶报告实验显示,在转染野生型载体WT-FLVCR1-AS1的SW480细胞中,共转染miR-381-3p mimics的荧光素酶活性低于共转染miR-con的细胞(P<0.05).结论 lncRNA FLVCR1-AS1可靶向调节miR-381-3p以促进CRC细胞增殖、抑制细胞凋亡,该作用可能通过上调Cleaved-Caspase-3表达及下调Cyclin D1表达实现.

目的:探讨色素内镜联合C反应蛋白(C-reactiveprotein,CRP)和转铁蛋白(Transferrin,TRF)在青海地区早期食管癌患者的诊断价值.方法:2018年6月至2020年3月选择在本院进行食管癌筛查的青海地区患者250例,所有患者都给予色素内镜检查,同时给予血浆CRP和TRF检查并判断诊断价值.结果:在250例患者中,病理诊断为原位癌28例,高级别上皮内瘤变10例,低级别上皮内瘤变12例,慢性炎症200例;其中早期食管癌38例.卢戈液色素内镜显示不染色47例,淡染色95例,浓染色108例.早期食管癌患者的血浆CRP值都高于非早期食管癌患者,TRF值低于(P＜0.05).Pearson相关性分析显示早期食管癌与色素内镜卢戈液不染色、CRP、TRF值存在相关性(P＜0.05).色素内镜联合CRP和TRF在青海地区早期食管癌的诊断敏感性与特异性分别为97.4％和100.0％.结论:色素内镜联合CRP和TRF在青海地区早期食管癌患者诊断中的应用具有很好的敏感性与特异性,能有效预测早期食管癌发生情况,对早期诊治早期食管癌具有一定的指导意义.

目的 探讨窄带成像技术(NBI)、卢戈液染色及超声内镜(EUS)联合测定血清C反应蛋白(CRP)、转铁蛋白(TRF)在青海地区老年早期食管癌的临床诊治价值.方法 选取2018年6月至2019年12月行普通内镜符合纳入标准的200例患者,应用EUS、NBI及卢戈液染色判断患者早期食管癌的病灶数量、浸润深度及IPCL分型,并与术后病理类型进行对比研究.通过酶联免疫吸附试验(ELISA)测定患者血清中CRP及TRF的表达量,并在进行相应治疗后的第1、3、7天对血清中CRP及TRF的表达量进行测定,并进行对比研究.结果 EUS对食管癌癌前病变及早期食管癌的检出率为58.3％,EUS+NBI检出率为86.1％,EUS+NBI+卢戈液染色检出率为100％.EUS判断病灶浸润深度的准确率为96.0％.NBI对高级别上皮内瘤变的判断准确度为90.9％,对早期食管癌的判断准确度为88.0％.术前活检有2例诊断不足,2例诊断过度.ELISA检测结果显示,患者组血清中CRP水平显著高于对照组,TRF表达量显著低于对照组(P<0.05).术后血清CRP的表达量在第3天最高,在术后60 d时基本与正常表达水平接近.术后血清TRF的表达量在术后逐渐增加,在术后60 d时恢复到正常水平.受试者工作特征(ROC)曲线分析结果显示,EUS+NBI+卢戈液染色+CRP+TRF对早期食管癌的检测灵敏度、特异性及准确度最高.结论 EUS、NBI及卢戈液染色联合测定血清CRP及TRF能有效提升早期食管癌的检出率,对进一步提高青海省早期食管癌的诊治水平、检出率并降低死亡率具有一定的指导作用.

目的 探讨内镜下电凝、钛夹联合注射肾上腺素治疗消化性溃疡出血的临床疗效.方法 选取210例消化性溃疡出血的患者,根据治疗方式分为3组,各70例.内镜注射组为内镜下注射肾上腺素,电凝组治疗方式为电凝联合注射肾上腺素,钛夹组为钛夹联合注射肾上腺素,术后观察比较3组止血效果与术后并发症情况.结果 3组首次止血率、止血失败率比较无统计学差异(P>0.05),止血成功率、再出血率比较差异显著(P<0.05).钛夹组止血成功率、再出血率与内镜注射组比较,差异有统计学意义(P<0.05).3组患者均未出现穿孔及其他并发症.结论 内镜下电凝、钛夹联合注射肾上腺素治疗消化性溃疡出血疗效相当,且创伤较小,并发症少.

目的 探讨在内镜下套扎序贯硬化剂治疗肝硬化并发食管胃底静脉曲张破裂出血(EGVB)患者的疗效及对患者血清胃泌素(GAS)、胰高血糖素(GLC)和血流动力学的影响.方法 2016年2月～2017年10月我院诊治的乙型肝炎肝硬化并发EGVB患者80例,采用随机数字表法将其分为研究组40例和对照组40例,给予对照组患者放置三腔二囊管、奥美拉唑和奥曲肽等内科常规止血治疗,研究组在此基础上待病情稳定后,采用内镜下套扎序贯硬化剂(EVLS)治疗.采用ELISA法检测血清GAS和GLC水平,使用KAI-X10四维彩色多普勒超声诊断仪检测门静脉压(PVP)、门静脉内径(PVD)、门静脉血流速度(PVV)和门静脉血流量(PVF).随访12个月.结果 在治疗2 w内,研究组死亡3例(7.5％),对照组死亡10例(25.0％),研究组止血有效率为92.5％,显著高于对照组的75.0％(P<0.05);研究组PVP、PVD和PVF分别为(22.5±1.6)mmHg、(11.7±0.4)mm和(546.2±131.6)ml/min,显著低于对照组的(25.3±2.0)mmHg、(13.8±0.5)mm和(742.6±162.8)ml/min(P<0.05);研究组血清GAS和GLC水平分别为(72.5±10.4)ng/L和(52.4±7.8)ng/L,显著低于对照组的(95.8±14.7)ng/L和(59.6±8.9)ng/L(P<0.05);随访12个月,研究组有2例(5.4％),而对照组有8例(26.7％,x2=4.114,P=0.043)发生再出血.结论 在内镜下采用EVLS治疗乙型肝炎肝硬化并发EGVB患者疗效好,且较为安全,远期效果仍有待观察.

神经内分泌肿瘤是一类起源于干细胞且具有神经内分泌功能的肿瘤,可发生于呼吸系统、消化系统等各个部位,最常见的是消化系统神经内分泌肿瘤.以往此类肿瘤习惯统称为"类癌",但肿瘤起源、激素分化活性等生物学行为均未能明确反映.这导致其早期诊断率较低,患者一旦发生转移则预后较差.本文报道1例混合病理类型的贲门下早期神经内分泌癌的普通内镜、色素内镜下特征性表现及ESD术前及术后病理表现.