早期食管癌病人内镜下黏膜剥离术后Barrett食管发生的影响因素  

Influencing factors of Barrett’s esophagus after endoscopic submucosal dissection in patients with early esophageal cancer

作　　者：张臻 柳林 朱祎曜 吴小波 ZHANG Zhen;LIU Lin;ZHU Yiyao;WU Xiaobo(Department of Thoracic Surgery,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi People’s Hospital,Nanjing Medical University Wuxi Medical Center,Wuxi 214000,China;不详)

机构地区：[1]南京医科大学附属无锡人民医院/无锡市人民医院胸外科,南京医科大学无锡医学中心,214000

出　　处：《临床外科杂志》2025年第1期89-91,共3页Journal of Clinical Surgery

基　　金：江苏省卫生健康委员会科研项目(20210334)。

摘　　要：目的探讨早期食管癌病人内镜下黏膜剥离术(endoscopic submucosal dissection,ESD)术后Barrett食管发生的影响因素。方法2022年1月~2023年3月行ESD治疗的早期食管癌病人110例,根据病人术后是否发生Barrett食管分为Barrett食管组(20例)和无Barrett食管组(90例)。对比两组病人一般临床资料、食管癌相关特征、ESD相关治疗特征。采用多因素logistic回归分析筛选早期食管癌病人ESD术后Barrett食管发生的危险因素。结果Barrett食管组病人中男性比例、既往饮酒史比例、既往吸烟史比例、消化道溃疡患病率、肿瘤多发比例、肿瘤最大直径、术后淋巴结转移率、术后远端转移率、术中损伤固有肌层比例均高于无Barrett食管组,差异有统计学意义(P<0.05);多因素logistic回归分析表明,饮酒史、吸烟史、消化道溃疡史、术后淋巴结转移、术后远端转移及术中损伤固有肌层是食管癌病人ESD术后Barrett食管发生的危险因素(P<0.05)。结论存在明确饮酒史、吸烟史,既往罹患消化道溃疡,术后淋巴结转移、术后远端转移且术中损伤固有肌层的食管癌病人ESD术后更容易发生Barrett食管。Objective To explore the influencing factors of Barrett’s esophagus after endoscopic submucosal dissection(ESD)in patients with early esophageal cancer.Methods 110 patients with esophageal cancer who received ESD therapy in our hospital from January 2022 to March 2023 were divided into two groups according to whether they had Barrett’s esophagus(n=20)and no Barrett’s esophagus(n=90).The general clinical data,esophageal cancer related characteristics and ESD related treatment characteristics of the two groups were compared.Multivariate regression analysis were used to screen the risk factors of Barrett’s esophagus in patients with esophageal cancer after ESD.Results The proportion of male,former drinking,former smoking,prevalence of peptic ulcer,multiple tumors,maximum diameter of tumors,the rate of postoperative lymph node metastasis,postoperative distant metastasis and the proportion of muscularis propria injury in patients with Barrett’s esophagus were significantly higher(P<0.05).Multivariate logistic regression analysis showed that alcohol drinking,smoking,peptic ulcer,postoperative lymph node metastasis,postoperative distant metastasis and injury of muscularis propria were the risk factors for Barrett’s esophagus(P<0.05).Conclusion Patients with a history of drinking,smoking,peptic ulcer,postoperative lymph node metastasis,postoperative distant metastasis and injury of muscularis propria are more likely to develop Barrett’s esophagus after ESD.

关 键 词：食管癌 内镜下黏膜剥离术 BARRETT食管 影响因素 

分 类 号：R73[医药卫生—肿瘤]