摘要目的:探讨下咽癌患者早期行胃镜检查的临床价值。方法:2010年1月—2014年12月在厦门大学附属第一医院诊治的231例下咽癌病例纳入回顾性分析，统计分析下咽癌患者和伴同时性食管癌(包括早期食管癌和进展期食管癌)患者的五年生存率，以及胃镜检查与全身PET-CT检查的同时性食管癌和同时性早期食管癌检出率。结果:下咽癌患者五年生存率为38.96%(90/231)。伴同时性食管癌62例，五年生存率为27.42%(17/62)；不伴同时性食管癌169例，五年生存率为43.20%(73/169)( χ2＝4.747， P＝0.029)。伴同时性早期食管癌患者49例，五年生存率为30.69%(17/49)；伴同时性进展期食管癌患者13例，无一例生存期达到五年，与伴同时性早期食管癌患者比较差异有统计学意义( P＝0.013)。同时性食管癌胃镜检查检出率为26.84%(62/231)，其中早期食管癌检出率为21.21%(49/231)；同时性食管癌全身PET-CT检查检出率为14.29%(33/231)( χ2＝11.14， P<0.01)，其中早期食管癌检出率为8.66%(20/231)( χ2＝14.328， P<0.01)。 结论:下咽癌伴同时性食管癌风险高，是影响患者生存率的重要因素。下咽癌患者早期行胃镜检查，可以显著提高同时性食管癌的检出率，有助于临床制定个体化治疗方案以提高患者的生存率。

abstractsObjective:To investigate the clinical value of early gastroscopy for patients with hypopharyngeal cancer.Methods:A total of 231 cases of hypopharyngeal cancer diagnosed and treated in the First Affiliated Hospital of Xiamen University from January 2010 to December 2014 were included in the retrospective analysis. The 5-year survival rate of hypopharyngeal cancer and patients accompanied with synchronous esophageal cancer (including early and advanced esophageal cancer), as well as the detection rate of synchronous esophageal cancer by gastroscopy and systemic PET-CT examination were statistically analyzed.Results:The 5-year survival rate of hypopharyngeal cancer was 38.96% (90/231). The 5-year survival rates of 62 patients accompanied with synchronous esophageal cancer and 169 patients without were 27.42% (17/62) and 43.20% (73/169), respectively, with statistic difference ( χ2=4.747, P=0.029). The 5-year survival rate of 49 patients accompanied with synchronous early esophageal cancer was 30.69% (17/49). Among the 13 patients with synchronous progressive esophageal cancer, none had a survival period of 5 years, which was significantly different compared with the patients with synchronous early esophageal cancer ( P=0.013). The detection rates of synchronous esophageal carcinoma by gastroscopy and by systemic PET-CT were 26.84% (62/231) and 14.29% (33/231), respectively, with statistic difference ( χ2=11.14, P<0.01). The detection rates of synchronous early esophageal carcinoma by gastroscopy and by systemic PET-CT were 21.21% (49/231) and 8.66% (20/231), respectively, and the difference was also statistically significant ( χ2=14.328, P<0.01). Conclusion:Hypopharyngeal cancer accompanied with synchronous esophageal cancer is of high risk, which affects the survival rate of patients. Early gastroscopy in hypopharyngeal cancer patients can significantly improve the detection rate of synchronous esophageal cancer, which helps to design individualized regimen to improve the survival rate of patients.