The Outcome Of Endoscopic Treatment And Microbiota Diversity Of Early Esophageal Squamous Cell Carcinoma

Objective 1.The study tense to assess the safety and long-term efficacy of the patients with the relative indications of Endoscopic Submucosal Dissection（ESD）treatment of early Esophageal Squamous Cell Carcinoma（ESCC）.2.The study tense to explore the microbial diversity in early esophageal squamous cell carcinoma tissues.Methods 1.The data of patients with relative indications for ESD of ESCC in Sichuan cancer hospital were collected from July 2015 to April 2021,and processed to analyze the safety,Progression-Free-Survival（PFS）and overall survival（OS）of ESD,and the influence of different adverse prognostic factors for long term out comes.2.The tissues of ESCC patients in Sichuan cancer hospital who received ESD from February2021 to August 2021 were collected.The microbiome from different stages of ESCC tissues were examined by 16 srRNA gene sequencing.The α diversity and β diversity and the abundance level of species in Genus classification were analyzed.Results 1.196 cases were included.According to the depth of pathology,the patients were grouped into M3（Muscularis）group（105）,SM1（Submucosa<200μm）group（50）and SM2（Submucosa≥200μm）group（41）,There were no significant differences in baseline data and safety indicators for ESD among the three groups.The R0 resection rate of the three groups was 100%,90%,70.7%,respectively（P<0.001）.Three-years PFS and OS were 97.1%,94.8%,85.3%（P=0.004）and 100%,100%,97.6%（P=0.22）,respectively.There was no significant difference in 3-year PFS between the three groups of the patients who could not tolerate surgery because of severe diseases,and the 3-years OS in M3 and SM1 groups of the patients with or without severe diseases was 100%,but the 3-years OS of the patients with severe disease in SM2 groups was94.4% slightly lower than the patients without severe diseases of 3-years OS 100%（P=0.025）.All patients about 3-yearas PFS and OS of curative resection group v.s.noncurative group were96% v.s.88%（P=0.005）and 100% v.s.98.7%（P=0.451）,respectively.The 3-years PFS and OS in difference differentiation,vertical margin,vascular infiltration was no significant difference（P>0.05）.The 3-years DFS in the 0,1,and ≥2 numbers of adverse prognostic factor group were 96%,90.9%,82.2%,respectively,（P=0.005）.2.According to the pathology,24 patients were grouped into precancerous（7 cases）,tumor doesn’t exceed the muscularis propria M1/M2（14 cases）,tumor does exceed the muscularis M3/SM（3cases）.The α diversity and β diversity of microbiota were no statistically significant differences in three groups（all P>0.05）.The analyses according to Genus classification.the microflora abundance was difference in three groups,but all groups were mainly Delftia.The abundance of Sphingomonas was gradually decreased and the abundance of Acinetobacter,Arthrobacter and Rhodococcus was gradually increased in three groups.The abundance of Arthrobacter was increasing was statistically significant difference in the three groups（P=0.03）.Conclusion 1.The safety of ESD treatment is higher in the patients with relative indications of ESCC.With the increase of infiltration depth,the risk of recurrence increase.The patients with severe diseases Who can’t tolerate surgery choose the ESD treatment also can have a better long-term survival.The patients with two or more numbers of adverse prognostic factors,additional therapy should be suggested for get better long-term outcomes.2.Acinetobacter、Arthrobacter、Rhodococcus may be related to the occurrence and development of esophageal cancer.