早期胃癌患者内镜黏膜下剥离术后发生同时性胃癌、异时性胃癌影响因素分析  

Analysis of influencing factors of synchronous gastric cancer and metachronous gastric cancer after endoscopic submucosal dissection in patients with early gastric cancer

作　　者：褚芮 朱敏 张颖[2] 王拥军[1] CHU Rui;ZHU Min;ZHANG Ying;WANG Yong-jun(Department of Gastroenterology;Department of Oncology,Beijing Friendship Hospital of Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院消化内科,北京100050 [2]首都医科大学附属北京友谊医院肿瘤内科,北京100050

出　　处：《临床军医杂志》2024年第9期907-910,913,共5页Clinical Journal of Medical Officers

基　　金：北京市自然科学基金资助项目(7244321)。

摘　　要：目的分析早期胃癌患者内镜黏膜下剥离术(ESD)后发生同时性胃癌(SGC)、异时性胃癌(MGC)的影响因素。方法回顾性分析首都医科大学附属北京友谊医院自2017年1月至2023年12月收治的1019例早期胃癌患者的临床资料。根据是否出现SGC、MGC,将患者分入单次病变组(未出现SGC或MGC)和多次病变组(出现SGC或MGC)。收集统计两组患者的临床资料和病理特征,采用Logistic回归模型分析早期胃癌患者ESD后发生SGC、MGC的影响因素。结果1019例患者中,出现SGC 7例、MGC 45例。两组年龄、吸烟史、初始多发病灶、初始病变部位、背景黏膜萎缩程度、肿瘤浸润深度、背景黏膜肠化程度、术后eCura分级情况比较,差异有统计学意义(P<0.05)。初始病变部位在胃下部、重度肠化、初始多发病灶、术后eCura分级为C级是早期胃癌患者ESD后发生SGC、MGC的独立危险因素(P<0.05)。结论初始病变部位在胃下部、重度肠化、初始多发病灶、术后eCura分级为C级的早期胃癌患者在ESD后具有较高的SGC、MGC发生风险,应延长随访时间。Objective To analyze the influencing factors of synchronous gastric cancer(SGC)and metachronous gastric cancer(MGC)in patients with early gastric cancer after endoscopic submucosal dissection(ESD).Methods The clinical data of 1019 patients with early gastric cancer admitted to Beijing Friendship Hospital of Capital Medical University from January 2017 to December 2023 were retrospectively analyzed.Patients were divided into single lesion group(no SGC or MGC)and multiple lesion group(SGC or MGC)according to the presence or absence of SGC or MGC.The clinical data and pathological characteristics of the two groups of patients were collected.Logistic regression model was used to analyze the influencing factors of SGC and MGC after ESD in patients with early gastric cancer.Results Among the 1019 patients,7 cases of SGC and 45 cases of MGC were found.There were statistically significant differences in age,smoking history,initial multiple lesions,initial lesion site,background mucosal atrophy degree,depth of tumor invasion,background mucosal enterification degree,and postoperative eCura grade between the two groups(P<0.05).Initial lesion location in the lower part of the stomach,severe enterification,initial multiple lesions,and postoperative eCura grade C were independent risk factors for SGC and MGC after ESD in patients with early gastric cancer(P<0.05).Conclusion Early gastric cancer patients with initial lesion location in the lower part of the stomach,severe enterification,initial multiple lesions,and postoperative eCura grade C have a higher risk of SGC and MGC after ESD,and the follow-up time should be extended.

关 键 词：早期胃癌 内镜黏膜下层剥离术 同时性胃癌 异时性胃癌 影响因素 

分 类 号：R735.2[医药卫生—肿瘤]