内镜黏膜下剥离术治疗早期胃癌的疗效及术后复发相关危险因素分析  

The Effect of Endoscopic Submucosal Dissection in the Treatment of Early Gastric Cancer and the Risk Factors Related to Postoperative Recurrence

作　　者：席婷[1] XI Ting(Department of Gastroenterology,Liaocheng People's Hospital,Liaocheng Shandong 252000,China)

机构地区：[1]聊城市人民医院消化内科,山东聊城252000

出　　处：《中华养生保健》2023年第13期175-178,共4页CHINESE HEALTH CARE

摘　　要：目的分析内镜黏膜下剥离术(ESD)治疗早期胃癌的疗效及术后复发相关危险因素,为ESD治疗早期胃癌提供依据。方法选取2017年1月—2019年1月聊城市人民医院收治的ESD治疗的200例早期胃癌患者作为研究对象,记录所有患者的性别、年龄、家族史、是否存在幽门螺杆菌感染、肿瘤大小、分化程度、病理类型、是否有转移、治疗情况、临床表现等。分析ESD治疗早期胃癌的疗效。随访3年,根据随访结果分为术后复发组及术后未复发组,比较两组患者的基本情况及临床资料,Logistic回归分析术后复发相关危险因素。结果本研究随访时间为10~36个月,截止2022年1月30日,平均随访时间为(30.35±5.01)个月,无死亡病例。患者复发情况:200例ESD治疗的早期胃癌患者共26例复发,复发率13.0%。所有复发患者均再次行ESD,均获得长期生存。通过对ESD治疗的早期胃癌患者术后复发的单因素及多因素分析发现:肿瘤大小(OR:3.981,95%CI:1.077~2.991)、浸润深度(OR:2.945,95%CI:1.946~4.997)、组织学分型(OR:2.909,95%CI:1.964~6.964)是术后复发的独立危险因素。结论ESD治疗早期胃癌的临床疗效好,肿瘤大小、浸润深度、组织学分型是术后复发的独立危险因素。Objective To analyze the efficacy of endoscopic submucosal dissection in the treatment of early gastric cancer and the risk factors related to postoperative recurrence,so as to provide evidence for ESD treatment of early gastric cancer.Methods 200 cases of early gastric cancer treated with ESD in Liaocheng People's Hospital from January 2017 to January 2019 were selected,and the gender,age,family history,presence of Helicobacter pylori infection,tumor size,differentiation,pathological type,metastasis,treatment and clinical manifestation of all patients were recorded.To analyze the efficacy of ESD in the treatment of early gastric cancer.After 3 years of follow-up,the patients were divided into two groups according to the follow-up.results postoperative recurrence group and postoperative non-recurrence group.The basic situation and clinical data of patients in the two groups were compared,and the risk factors related to postoperative recurrence were analyzed by logistic regression.Results Survival of patients:The follow-up time of this study was 10~36 months.As of January 30,2022,the average follow-up time was(30.35±5.01)months.There were no deaths.Recurrence of patients:26 of 200 patients with early gastric cancer treated with ESD recurred,with a recurrence rate of 13.0%.All relapsed patients were treated with ESD again and achieved long-term survival.Through univariate and multivariate analysis of postoperative recurrence of early gastric cancer patients treated with ESD,it was found that tumor size(OR:3.981,95%CI:1.077~2.991),depth of invasion(OR:2.945,95%CI:1.946~4.997),histological classification(OR:2.909,95%CI:1.964~6.964)were independent risk factors for postoperative recurrence.Conclusion ESD has a good clinical effect in the treatment of early gastric cancer.Tumor size,depth of invasion and histological classification are independent risk factors for postoperative recurrence.

关 键 词：内镜黏膜下剥离术 早期胃癌 疗效 术后复发 危险因素 

分 类 号：R735.2[医药卫生—肿瘤]