不同年龄段胃低级别上皮内瘤变患者内镜下射频消融术的疗效对比分析  

Comparative analysis of the efficacy of endoscopic radiofrequency ablation in patients with gastric low-grade intraepithelial neoplasia of different age groups

作　　者：王楠钧 马燕 李隆松 牛晓彤 刘圣圳 毕雅维 苏松 柴宁莉[1] 令狐恩强[1] Wang Nanjun;Ma Yan;Li Longsong;Niu Xiaotong;Liu Shengzhen;Bi Yawei;Su Song;Chai Ningli;Linghu Enqiang(Department of Gastroenterology,The First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心消化内科医学部,北京100853

出　　处：《中华胃肠内镜电子杂志》2024年第4期238-242,共5页Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)

基　　金：国家重点研发计划(2022YFC2503600);解放军总医院青年自主创新科学基金(22QNFC028)

摘　　要：目的探索内镜下射频消融术(RFA)治疗胃低级别上皮内瘤变(LGIN)的老年患者与非老年患者之间的疗效差异,为进一步提高RFA的临床疗效提供依据。方法回顾性纳入2014年10月至2022年10月经解放军总医院第一医学中心消化内科医学部行RFA治疗的胃LGIN且随访满2年的患者共104例,其中老年患者51例、非老年患者53例。对比两组患者在一般临床特征、内镜治疗及随访结果方面的差异,并探索其潜在原因。结果两组患者在年龄、萎缩性胃炎、肠上皮化生方面存在明显差异,在性别、病程、病变的部位、大小、表面形态、幽门螺旋杆菌感染、术后复发、再发,以及进展方面的差异无统计学意义。老年患者术后相对更容易复发,而萎缩性胃炎、肠上皮化生、Hp感染,以及病程超过1年可能是导致复发的潜在因素。结论胃LGIN的老年患者在RFA术后相对更容易复发。有效的控制萎缩性胃炎、肠上皮化生,积极根除Hp感染,并在确诊胃LGIN后尽早接受内镜下RFA,有望进一步改善RFA的疗效。Objective We conducted the clinical comparative studies to clarify the difference in efficacy between elderly patients and non-elderly patients with endoscopic radiofrequency ablation(RFA)for the treatment of gastric low-grade intraepithelial neoplasia(LGIN),and actively explored the possible causes to provide theoretical basis for further improving the clinical efficacy of RFA.Methods A total of 104 patients with gastric LGIN who received RFA at the First Medical Center of the Chinese PLA General Hospital from October 2014 to October 2022 and were followed up for more than 2 year were retrospectively selected,including 51 elderly patients and 53 non-elderly patients.Subsequently,through relevant statistical analysis,the differences in general information,endoscopy-related data,and follow-up results between the two groups were clarified,and the potential causes were explored.Results There were significant differences in age,atrophic gastritis and intestinal metaplasia between thetwogroups,but there were no statistically significant differences in gender,course of disease,lesion location,size,surface morphology,helicobacter pylori(Hp)infection,postoperative relapse,recurrence,and progression.Elderly patients are more likely to relapse after RFA,and atrophic gastritis,intestinal metaplasia,Hp infection,and disease duration of more than 1 year may be potential factors leading to relapse.Conclusion Elderly patients with gastric LGIN are relatively more likely to relapse after RFA.Effectively control atrophic gastritis and intestinal metaplasia,actively eradicate Hp infection,and receive endoscopic RFA as earlier as possible after the diagnosis of gastric LGIN are expected to further improve the efficacy of RFA.

关 键 词：胃低级别上皮内瘤变 内镜下射频消融术 老年 临床疗效 

分 类 号：R735.2[医药卫生—肿瘤]