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目的:分析分化型早期贲门癌的临床病理特点，并评价内镜黏膜下剥离术治疗的短期及长期疗效。方法:纳入2014年10月—2019年12月在南京鼓楼医院行内镜黏膜下剥离术治疗，且术后病理证实为分化型早期贲门癌的患者共329例（331个病灶），并进行随访。回顾患者的内镜及病理资料，分析分化型早期贲门癌的临床病理特征，评价内镜黏膜下剥离术治疗的短期（主要指标：整块切除率、治愈性切除率以及短期并发症发生率）及长期疗效（主要指标：异时性癌发生率、复发及远处转移率、总体生存率）。结果:329例分化型早期贲门癌患者男女比例约为4∶1，年龄（65.69±8.02）岁。肿瘤长径≤2.0 cm占65.9%（218/331）。病灶多位于后壁（50.5%，167/331），其次是小弯侧（36.3%，120/331）。内镜下形态0-Ⅱc型占49.5%（164/331）。69.8%（231/331）的病灶局限于黏膜层。整块切除率为100.0%（329/329），治愈性切除率为83.3%（274/329）。28例患者（8.5%）出现短期并发症。中位随访时间39个月，11例（3.3%）患者出现异时性癌，2例（0.6%）发生远处转移，无复发患者。有7例患者死亡，随访期间总体生存率97.9%（322/329）。其中治愈性切除追加外科手术患者生存率为100.0%（3/3），而未追加外科手术患者生存率为99.3%（269/271）；非治愈性切除追加外科手术患者生存率为96.0%（24/25），而未追加外科手术患者生存率为86.7%（26/30）。结论:分化型早期贲门癌大多数为高分化腺癌，发现时肿瘤直径多小于2 cm，合并溃疡及脉管浸润率较低。内镜黏膜下剥离术治疗分化型早期贲门癌安全有效，治愈性切除率高，术中及术后并发症少，异时性癌发生率、远处转移及复发率低，总体生存率高，但对于非治愈性切除患者推荐追加外科手术治疗。“,”Objective:To analyze the clinicopathological characteristics of differentiated early cardia cancer and to evaluate the short-term and long-term efficacy of endoscopic submucosal dissection (ESD).Methods:A total of 329 patients (331 lesions) who underwent ESD at Nanjing Drum Tower Hospital from October 2014 to December 2019 and were pathologically confirmed as differentiated early cardia cancer were included in the study and followed up. The endoscopic and pathological data of patients were reviewed to analyze the clinicopathological characteristics of differentiated early cardia cancer. The short-term (including en bloc resection rate, curative resection rate and incidence of short-term complications) and long-term efficacy (including incidence of metachronous cancer, recurrence and distant metastasis, and overall survival rate) of ESD was evaluated.Results:The ratio of male to female in 329 patients with differentiated early cardia cancer was 4∶1, and their age was 65.69±8.02 years. Tumor diameter of ≤2.0 cm accounted for 65.9% (218/331). Most lesions were located on the posterior wall (50.5%, 167/331), followed by the minor curve (36.3%, 120/331). The endoscopic morphology of 0-Ⅱc type accounted for 49.5% (164/331). There were 69.8% (231/331) lesions confined to the mucosal layer. The en bloc resection rate was 100.0% (329/329), and the curative resection rate was 83.3% (274/329). Short-term complications occurred in 28 patients (8.5%). With a median follow-up time of 39 months, 11 patients (3.3%) developed metachronous cancer, 2 (0.6%) developed distant metastasis, and no recurrence occurred. Seven patients died, and the overall survival rate during the follow-up period was 97.9% (322/329). The survival rate of patients with curative resection and additional surgery was 100.0% (3/3), while that without additional surgery was 99.3% (269/271). The survival rate of patients with non-curative resection and additional surgery was 96.0% (24/25), and that without additional surgery was 86.7% (26/30).Conclusion:Most differentiated early cardia cancers are well-differentiated adenocarcinomas, with less than 2 cm in diameter at the time of diagnosis with a low rate of ulcer and vascular invasion. ESD is safe and effective for the treatment of differentiated early cardia cancer with a high rate of curative resection, fewer intraoperative and postoperative complications, low incidences of metachronous cancer, distant metastasis and recurrence, and a high overall survival rate. However, additional surgical treatment is recommended for patients with non-curative resection.