Characteristics of early gastric tumors with different differentiation and predictors of long-term outcomes after endoscopic submucosal dissection  

作　　者：Hong-Yi Zhu Jie Wu Yuan-Miao Zhang Fang-Lan Li Jin Yang Bin Qin Jiong Jiang Ning Zhu Meng-Yao Chen Bai-Cang Zou 

机构地区：[1]Department of Gastroenterology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,Shaanxi Province,China [2]Department of Pathology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,Shaanxi Province,China [3]Department of Gastroenterology,Xianyang Hospital of Yan'an University,Xianyang 712000,Shaanxi Province,China [4]Department of Gastroenterology,The First Hospital of Xi'an,Xi'an 710000,Shaanxi Province,China

出　　处：《World Journal of Gastroenterology》2024年第14期1990-2005,共16页世界胃肠病学杂志（英文版）

基　　金：Supported by Development Program of Shaanxi Province,No.2021SF-221.

摘　　要：BACKGROUND Gastric cancer is a common malignant tumor of the digestive tract,and endosco-pic submucosal dissection(ESD)is the preferred treatment for early-stage gastric cancer.The analysis of the epidemiological characteristics of gastric mucosal tumors with different differentiation degrees and the influencing factors of long-term ESD efficacy may have certain significance for revealing the development of gastric cancer and ESD.AIM To analyze the features of gastric mucosal tumors at different differentiation levels,and to explore the prognostic factors of ESD.METHODS We retrospectively studied 301 lesions in 285 patients at The Second Affiliated Hospital of Xi'an Jiaotong University from 2014 to 2021,according to the latest Japanese guidelines(sixth edition),and divided them into low-grade intrae-pithelial neoplasia(LGIN),high-grade intraepithelial neoplasia(HGIN),and computed tomography at 3,6 and 12 months after ESD.We compared clinicopathologic characteristics,ESD efficacy,and complications with different degrees of differentiation,and analyzed the related factors associated with ESD.RESULTS HGIN and differentiated carcinoma patients were significantly older compared with LGIN patients(P<0.001)and accounted for more 0-IIc(P<0.001),atrophic gastritis was common(P<0.001),and irregular microvascular patterns(IMVPs)and demarcation lines(DLs)were more obvious(P<0.001).There was more infiltration in the undifferentiated carcinoma tissue(P<0.001),more abnormal folds and poorer mucosal peristalsis(P<0.001),and more obvious IMVPs,irregular microsurface patterns and DLs(P<0.05)than in the LGIN and HGIN tissues.The disease-free survival rates at 2,5,and 8 years after ESD were 95.0%,90.1%,and 86.9%,respectively.Undifferen-tiated lesions(HR 5.066),white moss(HR 7.187),incomplete resection(HR 3.658),and multiple primary cancers(HR 2.462)were significantly associated with poor prognosis.CONCLUSION Differentiations of gastric mucosal tumors have different epidemiological and endoscopic characteristics,which are closely rel

关 键 词：Gastric mucosal epithelial neoplasia Differentiated early gastric cancer Undifferentiated early gastric cancer Endoscopic submucosal dissection Long-term outcomes 

分 类 号：R735.2[医药卫生—肿瘤]