早期胃癌内镜下非治愈性切除后胃内再发的危险因素分析
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上海交通大学医学院附属仁济医院消化科 上海市消化疾病研究所

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Risk factors of cancer recurrence in stomach after non-curative endoscopic resection for early gastric cancer
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1.Department of Gastroenterology,Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine;2.Shanghai Institute of Digestive Disease

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    摘要:

    目的 探讨早期胃癌(EGC)非治愈性切除后胃内再发的危险因素。方法 收集2008年10月到2018年6月,于上海仁济医院消化内镜中心行早期胃癌内镜下治疗结果为非治愈性切除,并选择继续随访的59例患者相关资料,运用单因素Logistic回归分析胃内再发危险因素。结果 随访4~77个月,中位时长40个月,出现胃内再发11例,单因素Logistic回归分析显示淋巴脉管侵犯(OR=8.63,95%CI:1.24~60.04,P=0.030)和eCura高危分级(OR=7.31,95%CI:1.05~51.10,P=0.045)是胃内再发的危险因素。结论 非治愈性切除后可考虑常规行eCura分级评估,存在淋巴脉管侵犯或eCura分级高危者不建议继续随访;eCura分级低危者可继续行内镜随访,并注意观察原病灶周围是否存在异常。

    Abstract:

    Objective To analyze the risk factors of cancer recurrence in stomach after non-curative endoscopic resection for early gastric cancer (EGC). Methods Data of 59 patients with early gastric cancer, who underwent non-curative resection at endoscopy center of Shanghai Renji Hospital from October 2008 to June 2018, were analyzed with the univariate Logistic regression for the risk factors of cancer recurrence in the stomach. Results The follow-up period ranged from 4 to 77 months, with the median time of 40 months. There were 11 cases of cancer recurrence in the stomach. The univariate Logistic regression analysis showed lymphatic vessel invasion (OR=8.63, 95%CI: 1.24-60.04, P=0.030) and eCura high-risk grading (OR=7.31,95%CI: 1.05-51.10, P=0.045) were risk factors for cancer recurrence in the stomach. Conclusion The routine eCura grading assessment can be considered after non-cure resection. Patients with lymphatic vessel invasion or high-risk eCura category are not recommended for follow-up; patients with low-risk eCura grading can be followed up by regular endoscopy and attention should be paid to whether there are abnormalities around the original lesion.

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代子豪,李晓波.早期胃癌内镜下非治愈性切除后胃内再发的危险因素分析[J].中华消化内镜杂志,2019,36(12):897-900.

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  • 收稿日期:2018-11-18
  • 最后修改日期:2019-11-20
  • 录用日期:2019-01-02
  • 在线发布日期: 2019-12-27
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