内镜下黏膜切除术对早期胃癌患者肿瘤切除率、血清PG、CA125水平的影响  

Effects of Endoscopic Mucosal Resection on Tumor Resection Rate and Levels of Serum PG and CA125 in Patients with Early Gastric Cancer

作　　者：陈敬成 肖小梅 CHEN Jingcheng;XIAO Xiaomei(Affiliated Hospital of Jinggangshan University,Ji’an 343000,China;不详)

机构地区：[1]井冈山大学附属医院,江西吉安343000 [2]江西省吉安市中心血站

出　　处：《中国医学创新》2022年第19期153-157,共5页Medical Innovation of China

摘　　要：目的:分析内镜下黏膜切除术(EMR)对早期胃癌(EGC)患者肿瘤切除率、血清胃蛋白酶原(PG)、糖类抗原125(CA125)水平的影响。方法:回顾性分析2019年5月-2021年6月于井冈山大学附属医院就诊的120例EGC患者的临床资料。根据手术方法分为观察组(n=70)和对照组(n=50)。观察组采用EMR治疗,对照组采用保留幽门胃切除术治疗。比较两组患者围手术期指标(手术时间、术中出血量、住院时间)及肿瘤切除率(完全切除率、基底病灶残余率);比较两组术前1 d及术后30 d时的血清PGⅠ、PGⅡ、PGⅠ与PGⅡ比值(PGR)及CA125水平;比较两组术前1 d及术后6个月时的营养状况指标[体重指数(BMI)、血红蛋白(Hb)、血清总蛋白(TP)];记录两组围手术期不良事件发生情况。结果:观察组手术时间及住院时间均短于对照组、术中出血量显著少于对照组,差异均有统计学意义(P<0.05);观察组完全切除率为72.86%,基底病灶残余率为8.57%,对照组完全切除率为84.00%,基底病灶切除率为4.00%,组间比较差异均无统计学意义(P>0.05);术后30 d时两组血清PGⅠ、PGR水平较术前1 d均显著升高,血清PGⅡ、CA125水平较术前1 d均显著降低(P<0.05),组间血清PGⅠ、PGR水平比较,差异均有统计学意义(P<0.05),组间血清PGⅡ、CA125水平比较,差异均无统计学意义(P>0.05);术后6个月时,两组BMI、Hb及TP水平较术前1 d均明显升高,且观察组均显著高于对照组(P<0.05);两组术中急性出血、迟发性出血、穿孔及切口感染发生率比较,差异均无统计学意义(P>0.05),观察组餐后恶心、呕吐发生率显著低于对照组,组间比较差异有统计学意义(P<0.05)。结论:EMR术和保留幽门胃切除术治疗EGC均可有效切除病灶,但前者在降低术中出血,调节血清PG及CA125水平、改善术后营养状况方面优势显著。Objective:To analyze the effects of endoscopic mucosal resection(EMR)on tumor resection rate and levels of serum pepsinogen(PG)and carbohydrate antigen 125(CA125)in patients with early gastric cancer(EGC).Method:The clinical data of 120 patients with EGC who were treated in the Affiliated Hospital of Jinggangshan University were retrospectively analyzed from May 2019 to June 2021.According to the surgical methods,they were divided into observation group(n=70)and control group(n=50).The observation group was treated with EMR,and the control group was treated with pylorus-preserving gastrectomy.The perioperative indicators(surgical time,intraoperative blood loss,hospital stay)and tumor resection rate(complete resection rate,residual rate of basal lesions)were compared between the two groups;levels of serum PGⅠ,PGⅡ,PGⅠ/PGⅡratio(PGR)and CA125 at 1 d before surgery and at 30 d after surgery were compared between the two groups;the nutritional status indexes[body mass index(BMI),hemoglobin(Hb)and serum total protein(TP)]at 1 d before surgery and 6 months after surgery were compared between the two groups;the occurrence of perioperative adverse events in the two groups were recorded.Result:The surgical time and hospital stay in observation group were shorter than those in control group,intraoperative blood loss in observation group was significantly less than that in control group(P<0.05);the complete resection rate and residual rate of basal lesions were 72.86%and 8.57%in observation group,the complete resection rate and residual rate of basal lesions were 84.00%and 4.00%in control group,there were no significant differences between the two groups(P>0.05);the levels of serum PGⅠand PGR in the two groups at 30 d after surgery were significantly increased while the levels of serum PGⅡand CA125 were significantly decreased compared to those 1 d before surgery(P<0.05),and there were statistical differences in the levels of serum PGⅠand PGR between the two groups(P<0.05),but there were no significant differenc

关 键 词：内镜下黏膜切除术 胃癌 保留幽门胃切除术 切除率 胃蛋白酶原 

分 类 号：R735.2[医药卫生—肿瘤]