内镜黏膜下剥离术治疗早期胃癌术后复发的相关因素分析

Risk factors of recurrence for early gastric cancer after endoscopic submucosal dissection

摘要:

目的 探讨内镜黏膜下剥离术（ESD）治疗早期胃癌（EGC）的术后复发情况及相关危险因素。方法 回顾性分析2016年1月－2019年12月青海省人民医院消化内科实施ESD治疗且病理结果为EGC的258例患者的临床及随访资料，分析影响术后复发的相关因素。结果 258例患者术后均获得长期随访，随访期间14例复发，复发率为5.4%，平均复发时间为（10.6±4.3）个月。经单因素和多因素统计分析，病变浸润深度为SM2或以上（OR＾ = 5.22，95%CI：1.257～21.648，P = 0.023）、病变最大径 ≥ 4.0 cm（OR＾ = 5.23，95%CI：1.331～20.568，P = 0.018）是影响ESD术后复发的独立危险因素。结论 ESD治疗EGC临床疗效好，病变的浸润深度及大小是影响ESD术后复发的独立危险因素。

Abstract:

Objective To investigate the recurrence and related risk factors of early gastric cancer (EGC) after endoscopic submucosal dissection (ESD).Methods The clinical data of 258 patients with early gastric cancer who received ESD treatment from January 2016 to December 2019 were retrospectively analyzed, the related factors influencing postoperative recurrence were analyzed.Results 258 patients were followed up for a long time. 14 cases recurred during the follow-up period, the recurrence rate was 5.4%, and the average recurrence time was (10.6 ± 4.3) months. By univariate and multivariate statistical analysis, the depth of invasion was SM2 or above (OR＾ = 5.22, 95%CI: 1.257 ~ 21.648, P = 0.023), and the maximum diameter of lesion ≥ 4.0 cm (OR＾ = 5.23, 95%CI: 1.331~20.568, P = 0.018) were independent risk factors for recurrence after ESD.Conclusion ESD has good clinical efficacy in the treatment of EGC. The depth and size of the lesions were independent risk factors for recurrence after ESD.