行内镜黏膜下剥离术治疗的近端及远端早期胃癌患者临床病理特征对比  

Comparison of Clinicopathological Features of Patients with Proximal and Distal Early Gastric Cancer Treated with Endoscopic Submucosal Dissection

作　　者：王琳 轩小燕[1] WANG Lin;XUAN Xiaoyan(School of Basic Medicine,Zhengzhou University,Zhengzhou 450001,China;Department of Pathology,Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]河南省郑州大学基础医学院,河南郑州450001 [2]河南省郑州大学第二附属医院病理科,河南郑州450000

出　　处：《中国伤残医学》2025年第7期100-103,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:对比行内镜黏膜下剥离术(ESD)治疗的近端与远端早期胃癌患者的临床病理特征。方法:回顾性分析2021年4月—2024年4月于郑州大学第二附属医院接受ESD治疗且行术后病理检查的180例早期胃癌患者资料,依据病变位置不同将其分为远端病变组(n=124)和近端病变组(n=56)。比较两组临床资料(性别、年龄、既往史)与病理资料(肿瘤直径、内镜分型、浸润深度、组织分化类型、有无侵犯淋巴管、有无浸润静脉、Snail蛋白表达、E-钙黏蛋白表达),并比较两组的ESD治愈情况、淋巴结转移风险与随访复发率。结果:近端病变组的肿瘤直径小于远端病变组,内镜下浅表平坦型占比、黏膜下层浸润占比、Snail蛋白高表达率、E-钙黏蛋白低表达率分别为30.36%、21.43%、75.00%、67.86%,均高于远端病变组的9.68%、8.06%、29.84%、33.87%,差异均有统计学意义(P<0.05)。近端病变组的ESD完全缓解率、随访复发率分别为69.64%、1.78%,与远端病变组的78.23%、0.00%比较,差异均无统计学意义(P>0.05);两组的非治愈性切除患者淋巴结转移风险比较,差异无统计学意义(P>0.05)。结论:远端病变的早期胃癌肿瘤直径较大,黏膜下层浸润较少,近端病变的早期胃癌浅表平坦型较多,且Snail多高表达,E-钙黏蛋白多低表达。不同病变位置的早期胃癌ESD切除效果、淋巴结转移风险与随访复发率无明显差别。Objective:To compare the clinicopathological features of patients with proximal and distal early gastric cancer treated by endoscopic submucosal dissection(ESD).Methods:Data of 180 patients with early gastric cancer who received ESD treatment and underwent postoperative pathological examination in the Second Affiliated Hospital of Zhengzhou University from April 2021 to April 2024 were retrospectively analyzed,and were divided into the distal lesion group(n=124)and the proximal lesion group(n=56)according to different lesion locations.The clinical data(gender,age,past history)and pathological data(tumor diameter,endoscopic classification,depth of invasion,tissue differentiation type,lymphatic vessel invasion,venous invasion,Snail protein expression,e-cadherin expression)of the two groups were compared,and the ESD healing status,lymph node metastasis risk and follow-up recurrence rate of the two groups were compared.Results:The tumor diameter of the proximal lesion group was smaller than that of the distal lesion group,the proportions of superficial flat type,submucosal infiltration,Snail protein high expression rate and E-cadherin low expression rate under endoscopy were 30.36%,21.43%,75.00%and 67.86%,respectively,which were higher than 9.68%,8.06%,29.84%and 33.87%of the remote lesion group,the differences were statistically significant(P<0.05).The complete remission rate of ESD and recurrence rate in the proximal lesion group were 69.64%and 1.78%,respectively,compared with 78.23%and 0.00%in the distal lesion group,there were no significant differences(P>0.05);there was no significant difference in the risk of lymph node metastasis between the two groups(P>0.05).Conclusion:Early gastric cancer with distal lesions has larger tumor diameter and less submucosal invasion,while early gastric cancer with proximal lesions has more superficial flat type,higher Snail expression and lower E-cadherin expression.There were no significant differences in ESD resection effect,lymph node metastasis risk and follow-up recurrence

关 键 词：早期胃癌 胃远端病变 胃近端病变 内镜黏膜下剥离术 临床特征 病理特征 

分 类 号：R735.2[医药卫生—肿瘤]