早期胃癌内镜黏膜下剥离术C-2级切除的风险因素
Risk Factors for Endoscopic Submucosal Dissection C-2 Resection in Early Gastric Cancer
DOI: 10.12677/ACM.2022.122161, PDF,    国家自然科学基金支持
作者: 王剑舒, 李晓宇, 王占军, 刘建勋, 毛 涛*：青岛大学附属医院消化内科，山东 青岛；张雪琳：射阳县人民医院消化内科，江苏 盐城
关键词: 早期胃癌；内镜黏膜下剥离术；内镜治愈度；非治愈性；手术；Early Gastric Cancer； Endoscopic Submucosal Dissection； Endoscopic Curability； Non-Curative； Surgery
摘要: 目的：明确早期胃癌(Early gastric cancer, EGC)经内镜黏膜下剥离术(Endoscopic submucosal dissection, ESD)内镜治愈度(Endoscopic curability, eCura) C-2切除的风险因素。方法：回顾性收集2017年10月至2021年9月于青岛大学附属医院经ESD治疗的658个EGC病灶，根据病灶的治愈情况分为eCura C-2 ESD组与非eCura C-2 ESD组，分析两组的临床及病理特征。结果：65 (9.9%)个病灶经ESD eCura C-2切除。单因素分析提示男性患者，吸烟史，饮酒史，癌胚抗原 > 3.4 g/L，多发EGC，肿瘤位于贲门、胃底或胃体，未分化型组织学，混合组织学，以及病灶直径 > 20 mm均与ESD eCura C-2切除相关(P均 < 0.05)。多因素分析确认ESD eCura C-2切除的独立风险因素为肿瘤位于贲门(OR = 13.254, P < 0.001)、胃底或胃体(OR = 3.702, P < 0.001)，未分化型组织学(OR = 8.918, P < 0.001)，混合组织学(OR = 4.551, P < 0.001)，病灶直径 > 20 mm (OR = 4.918, P < 0.001)，多发EGC (OR = 2.871, P = 0.026)，以及吸烟史(OR = 2.004, P = 0.036)。结论：具有上述ESD eCura C-2切除独立风险因素的EGC病灶应更加彻底地剥离。
Abstract: Objective: To clarify the risk factors for endoscopic curability (eCura) C-2 endoscopic submucosal dissection (ESD) in early gastric cancer (EGC). Methods: 658 EGCs who underwent ESD between October 2017 and September 2021 at the Affiliated Hospital of Qingdao University were retrospectively collected. All enrolled EGCs were divided into eCura C-2 ESD group and non-eCura C-2 ESD group according to the curability. The clinicopathological characteristics of the two groups were analyzed. Results: 65 (9.9%) lesions underwent eCura C-2 ESD. Univariate analysis revealed that male sex, smoking and drinking history, carcinoembryonic antigen level > 3.4 g/L, multiple EGCs, tumors located in cardia, fundus or corpora, undifferentiated histology, mixed histology and lesion size > 20 mm were associated with eCura C-2 ESD (All the above factors, P < 0.05). Multivariate analysis confirmed that tumors located in cardia (OR = 13.254, P < 0.001), fundus or corpora (OR = 3.702, P < 0.001), undifferentiated histology (OR = 8.918, P < 0.001), mixed histology (OR = 4.551, P < 0.001), lesion size > 20 mm (OR = 4.918, P < 0.001), multiple EGCs (OR = 2.871, P = 0.026) and smoking history (OR = 2.004, P = 0.036) were independent risk factors for eCura C-2 ESD. Conclusions: EGCs with independent risk factors for eCura C-2 ESD described above should be more thoroughly resected.
文章引用：王剑舒, 李晓宇, 张雪琳, 王占军, 刘建勋, 毛涛. 早期胃癌内镜黏膜下剥离术C-2级切除的风险因素[J]. 临床医学进展, 2022, 12(2): 1095-1104. https://doi.org/10.12677/ACM.2022.122161

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