56例早期胃癌患者临床病理特征及诊治

Early gastric cancer: Clinical features and therapeutic experience in 56 cases

目的:分析早期胃癌的临床病理特征,探讨影响其淋巴结转移的因素,评价内镜黏膜下剥离术(ESD)治疗的疗效及安全性。方法:收集2013年3月~2016年10月我院诊治的早期胃癌病例资料,分析病人性别、年龄、病变大小、部位、形态、分化程度、浸润深度、合并溃疡是否与淋巴结转移相关,根据ESD术后病理分析早期胃癌ESD治疗的完全切除率、治愈性切除率和并发症情况。结果:56例早期胃癌的淋巴结转移率为14.28%,单因素分析显示分化程度及浸润深度与早期胃癌淋巴结转移相关,多因素Logistic回归分析显示浸润深度是早期胃癌淋巴结转移的独立危险因素(OR=6.333,P<0.05)。ESD治疗22例早期胃癌的完全切除率为90.9%,治愈性切除率为86.4%,仅1例发生迟发性出血。结论:早期胃癌淋巴结转移与分化程度及浸润深度有关,ESD治疗早期胃癌具有良好的应用前景。

Objective:To assess the efficacy and safety of endoscopic submucosal dissection(ESD)in early gastric cancer through analysis of the clinicopathological properties and factors affecting the lymph node metastasis of this clinical entity.Methods:Clinical data were reviewed in the patients of early gastric cancers treated in our hospital between March 2013 and October 2016 for analysis of the relationship between gender,age,lesion size,location,morphology,differentiation,depth of invasion and lymph node metastasis.Other information was also analyzed on the complete resection rate,curative resection rate and complications of ESD based on the pathological findings.Results:The rate of lymph node metastasis was 14.28%in the 56 cases of early gastric cancer.Univariate analysis showed that the differentiation and invasion depth were correlated with lymph node metastasis,and multivariate logistic regression analysis indicated that invasion depth was the independent risk factor for lymph node metastasis in early gastric cancer(OR=6.333,P<0.05).The complete resection rate and curative resection rate of ESD in early gastric cancer were 90.9%and 86.4%,respectively.Delayed bleeding occurred in only 1 case.Conclusion:Lymph node metastasis in early gastric cancer is associated with the degree of differentiation and depth of invasion,and ESD is promising in the treatment of early gastric cancer.