内镜黏膜下剥离术治疗早期胃癌的长期疗效及随访观察  

Long-term Efficacy and Follow-up Observation of Endoscopic Submucosal Dissection in the Treatment of Early Gastric Cancer

作　　者：陈亚杰 陈卫刚[1] 魏银 罗丽娜 常钰朋 尚国臣[1] 刘浩[1] 田书信[1] CHEN Ya-jie;CHEN Wei-gang;WEI Yin;LUO Li-na;CHANG Yu-peng;SHANG Guo-chen;LIU Hao;TIAN Shu-xin(The First Affiliated Hospital of Shihezi University School of Medicine,Xinjiang Shihezi,832008)

机构地区：[1]石河子大学医学院第一附属医院,新疆石河子832008

出　　处：《农垦医学》2021年第4期294-298,共5页Journal of Nongken Medicine

基　　金：石河子大学重大科技攻关项目(GXJS2014-ZDGG07)。

摘　　要：目的:探讨早期胃癌患者行内镜黏膜下剥离术后的长期随访疗效。方法:回顾性分析2009年1月至2015年12月在石河子大学第一附属医院经ESD治疗且术后病理诊断为早期胃癌,随访资料完整的36例患者。收集患者的一般资料、内镜资料、病理资料和术后随访情况等进行分析。结果:36例患者随访8~126个月,其中男性26例(72.2%),女性10例(27.8%),平均年龄为(66.17±10.30)岁;病灶部位在胃上中下位置各为4例(11.1%)、12例(33.3%)、20例(55.6%);病灶直径大小中位数为1.5cm(0.8,2);病例中多灶病变3例(8.3%),微小癌1例(2.8%);病灶组织学类型分类:高级别上皮内瘤变21例(58.3%)、腺癌13例(36.1%)、印戒细胞癌1例(2.8%)、神经内分泌肿瘤1例(2.8%);病灶整块切除率、完全切除率、治愈性切除率分别为97.2%、94.4%、80.6%。随访中1例因异时性癌转移死亡,1例因外科手术并发症死亡,随访五年整体生存率94.4%,肿瘤特异性生存率97.2%。结论:ESD治疗早期胃癌具有较高的安全性和有效性,根据指南规范随访至关重要。Objective:To investigate the long-term follow-up effect of endoscopic submucosal dissection(ESD)in patients with early gastric cancer(EGC).Methods:36 patients with early gastric cancer diagnosed by postoperative pathology and complete follow-up data treated by ESD in the first affiliated Hospital of Shihezi University from January 2009 to December 2015 were analyzed retrospectively.The general data,endoscopic data,pathological data and postoperative follow-up were collected and analyzed.Results:36 patients were followed up for 8-126 months.There were 26 males(72.2%)and 10 females(27.8%).The average age was(66.17±10.30).The lesions were located in the upper,middle and lower part of the stomach in 4 cases(11.1%),12 cases(33.3%)and 20 cases(55.6%),respectively.The median of diameter among the focus was 1.5cm(0.8,2),and there were 3 cases of multiple lesions(8.3%)and 1 case of microcarcinoma(2.8%).Histological classification of lesions:high-grade intraepithelial neoplasia(HGIN)in 21 cases(58.3%),adenocarcinoma in 13 cases(36.1%),signet ring cell carcinoma in 1 case(2.8%),neuroendocrine tumor in 1 case(2.8%).The overall resection rate,complete resection rate and cure resection rate were 97.2%,94.4%and 80.6%,respectively.Two patients died of metastatic gastric cancer,and the five-year overall survival rate was 94.4%after follow-up,the cancer specific survival rate was 97.2%.Conclusion:ESD is safe and effective in the treatment of early gastric cancer,and follow-up according to the guidelines is very important.

关 键 词：内镜黏膜下剥离术 早期胃癌 疗效分析 eCura评分 

分 类 号：R735.2[医药卫生—肿瘤]