内镜黏膜下剥离术治疗早期胃癌复发及影响因素分析  

Endoscopic Submucosal Dissection for Recurrence of Early Gastric Cancer and the Influencing Factors

作　　者：李韶华[1] 谢华红[1] 幺立萍[1] 王新[1] 柯小茹 刘清[1] LI Shao-hua;XIE Hua-hong;YAO Li-ping;WANG Xin;KE Xiao-ru;LIU Qing(Department of Gastroenterology, Xijing Hospital, the Fourth Military Medical University, Xi'an 710032, China)

机构地区：[1]第四军医大学西京医院消化内科

出　　处：《临床误诊误治》2019年第9期58-61,共4页Clinical Misdiagnosis & Mistherapy

基　　金：陕西省科学技术研究发展计划项目(2016SF-034)

摘　　要：目的 分析内镜黏膜下剥离术(endoscopic submucosal dissection, ESD)治疗早期胃癌复发的影响因素。方法 选取我院 150例早期胃癌,均行ESD治疗。观察治疗效果,记录一般资料,分析影响病情复发的相关因素。结果 本组11例失访,22例病情复发。单因素分析显示,早期胃癌患者ESD术后病情复发组肿瘤浸润深度达黏膜下层、术前未行超声内镜检查、手术切缘阳性所占比例显著高于病情未复发组( P <0.05)。多因素logistic回归分析显示,肿瘤浸润深度达黏膜下层、术前未行超声内镜检查、手术切缘阳性是早期胃癌患者ESD术后病情复发的独立危险因素( P <0.05)。结论 ESD治疗早期胃癌的临床效果较好,肿瘤浸润深度达黏膜下层、术前未行超声内镜检查、手术切缘阳性是早期胃癌患者ESD术后病情复发的影响因素,临床应采取相应措施以改善预后。Objective To analyze the influencing factors of endoscopic submucosal dissection (ESD) in the treatment of recurrence of early gastric cancer. Methods A total of 150 patients with early gastric cancer treated in our hospital were enrolled, and underwent ESD. And they were followed up for 1.5 to 5 years, and the curative effect was observed. The general data were recorded, and the relevant factors influencing recurrence of the disease were analyzed. Results There were 11 patients lost to follow up and 22 cases with disease recurrence. Univariate analysis showed that after ESD for patients with early gastric cancer, proportion of depth of submucosal tumor infiltration, no preoperative endoscopic ultrasonography and positive surgical margin in recurrence group were significantly higher than those in non-recurrence group ( P <0.05). Multivariate logistic regression analysis showed that depth of submucosal tumor infiltration, no preoperative endoscopic ultrasonography and positive surgical margin were independent risk factors for disease recurrence in early gastric cancer patients after ESD ( P <0.05). Conclusion The clinical effect of ESD is good in the treatment of early gastric cancer. The depth of submucosal tumor infiltration, no preoperative endoscopic ultrasonography and positive surgical margin are risk factors for disease recurrence in early gastric cancer patients after ESD. Therefore, relevant measures should be taken to improve prognosis of patients in clinical practice.

关 键 词：胃肿瘤 内镜黏膜下剥离术 治疗结果 影响因素分析 

分 类 号：R735.2[医药卫生—肿瘤]