结直肠神经内分泌肿瘤患者ESD后淋巴结转移情况及其与SATB2的相关性  

Lymph node metastasis status after ESD in patients with colorectal neuroendocrine neoplasms and its correlation with SATB2

作　　者：金瑞[1] 余涛[2] 陈志娟[1] JIN Rui;YU Tao;CHEN Zhijuan(Digestive Medicine Department,Hanzhong Central Hospital,Hanzhong 723000;Digestive Medicine Department,Hanzhong People's Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市中心医院消化内科,陕西汉中723000 [2]汉中市人民医院消化内科,陕西汉中723000

出　　处：《临床医学研究与实践》2024年第2期17-20,共4页Clinical Research and Practice

基　　金：汉中市中心医院院级科研基金中标项目(No.YK1912)。

摘　　要：目的探讨结直肠神经内分泌肿瘤(NENs)患者内镜黏膜下剥离术(ESD)后淋巴结转移情况及与特异性AT序列结合蛋白2(SATB2)的相关性。方法纳入2018年1月至2023年1月汉中市中心医院收治的158例结直肠NENs患者,均行ESD治疗。记录所有患者的手术和随访结果,包括整块切除率、切缘阳性率、淋巴结转移率。根据患者随访期间淋巴结转移情况分为转移组和对照组,记录两组的临床资料并进行比较。使用二元Logistic回归分析影响结直肠NENs患者ESD后淋巴结转移的危险因素,用受试者工作特征(ROC)曲线分析SATB2对患者ESD后淋巴结转移的预测价值。结果158例患者ESD均为整块切除,整块切除率为100.00%,14例(8.86%)患者切缘阳性。随访期间淋巴结转移21例(13.29%)纳入转移组,无淋巴转移137例纳入对照组。两组的肿瘤分期、肿瘤直径、淋巴管浸润、SATB2阳性比较,差异具有统计学意义(P<0.05)。二元Logistic回归分析结果显示,肿瘤分期、肿瘤直径、淋巴管浸润为结直肠NENs患者ESD后淋巴结转移的危险因素,SATB2阳性为保护性因素(P<0.05)。ROC曲线显示,SATB2对结直肠NENs患者ESD后淋巴结转移预测的曲线下面积(AUC)为0.747(95%CI 0.626~0.867),灵敏度为57.69%,特异度为91.67%。结论结直肠NENs患者ESD后淋巴结转移的发生与肿瘤分期、肿瘤直径、淋巴管浸润、SATB2表达相关,其中SATB2可作为患者淋巴结转移评估的有效指标。Objective To investigate the lymph node metastasis status after endoscopic submucosal dissection(ESD)in patients with colorectal neuroendocrine neoplasms(NENs)and its correlation with special AT-rich sequence binding protein 2(SATB2).Methods A total of 158 patients with colorectal NENs admitted in Hanzhong Central Hospital from January 2018 to January 2023 were included and treated with ESD.The surgical and follow-up results of all patients were recorded,including en bloc resection rate,positive margin rate,and lymph node metastasis rate.According to the lymph node metastasis during the follow-up period,the patients were divided into metastasis group and control group.The clinical data of the two groups were recorded and compared.Binary Logistic regression analysis was used to analyze the risk factors affecting lymph node metastasis after ESD in patients with colorectal NENs.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of SATB2 for lymph node metastasis after ESD.Results The ESD of 158 patients was en bloc resection,the en bloc resection rate was 100.00%,14 patients(8.86%)had positive resection margin.During the follow-up period,21 cases(13.29%)with lymph node metastasis were included in the metastasis group,and 137 cases without lymph node metastasis were inclueed in the control group.There were significant differences in tumor stage,tumor diameter,lymphatic invasion and SATB2 positive between the two groups(P<0.05).The results of binary Logistic regression analysis showed that tumor stage,tumor diameter and lymphatic invasion were risk factors for lymph node metastasis after ESD in patients with colorectal NENs,and SATB2 positive was a protective factor(P<0.05).ROC curve showed that the area under curve(AUC)of SATB2 in predicting lymph node metastasis after ESD in patients with colorectal NENs was 0.747(95%CI 0.626-0.867),the sensitivity was 57.69%,and the specificity was 91.67%.Conclusion The occurrence of lymph node metastasis after ESD in patients with colorectal N

关 键 词：结直肠神经内分泌肿瘤 内镜黏膜下剥离术 淋巴管浸润 特异性AT序列结合蛋白2 

分 类 号：R735.73[医药卫生—肿瘤]