内镜下切除与根治性切除治疗早期胃癌疗效对比

Curative effectiveness of endoscopic resection vs. gastrectomy for early gastric cancer

目的探讨内镜下切除（ER）与胃切除（GR）治疗早期胃癌的疗效差异。方法收于我院就诊并诊断为早期胃癌，分别接受内镜下切除和胃切除治疗的183例患者的临床资料。按治疗方案不同将患者分为内镜治疗组（ER）和胃切除组（GR），比较组问患者年龄分布、性别构成、既往史（基础疾病）、肿瘤位置（上端癌、中部癌、下端癌）、肿瘤大小（直径）、肿瘤分化程度及大体分型等基础状况的差异及术后并发症发生率、总体生存时间和无瘤生存时间的差异。结果按照接受治疗方案的不同，将183例患者分为GR组128例，ER组55例。患者年龄分布、性别构成及合并基础疾病等一般情况比较，组间差异无统计学意义（P〉0．05）；患者疾病临床病理特征比较，患者肿瘤位置、分化程度及大体分型比较，组间差异无统计学意义（P〉0．05），然而与ER比较，GR组患者肿瘤相对较大[（1．62±0．55）cm比（1．31±0．42）cm]，组间差异有统计学意义（P〈0．05）；并发症发生率比较，组间差异无统计学意义（P〉0．05）；患者总体生存时间与无瘤生存时问比较，组间差异无统计学意义（P〉0．05）。结论对于符合内镜下切除治疗绝对适应证的早期胃癌患者，ER治疗效果与GR相当，可以考虑选择ER作为其常规治疗方案。

Objective To investigate the the curative effectiveness of Endoscopic resection （ER） vs. Gastrectomy （GR） for early gastric cancer. Methods The clinical data of 183 patients who were diag- nosed with early gastric cancer, and accepted ER or GR in our department were collected. Patients were divided into ER group and GR group. The differences in age distribution, gender composition, underlying disease, position, diameter and morphology of tumor were compared between two groups. The differences in the incidence rate of complications, overall survival rate and recurrence free survival rate were also com- pared between two groups. Results All the 183 patients were divided into GR group （n = 128） and ER group （ n= 55 ）. There was no significance difference in age distribution, gender composition, and underly- ing disease between two groups. There was no significant difference in position and morphology of tumors between two groups, but the tumor diameter in the GR group was bigger than in the ER group. There was no significance difference in the incidence rate of complications, overall survival rate and recurrence free survival rate between two groups. Conclusion For patients diagnosed with early gastric cancer meeting the absolute indications of ER, ER showed the same curative effectiveness as GR, and can be considered as a regular treatment for early gastric cancer.