中青年与老年早期胃癌患者临床病理特征及内镜黏膜下剥离术后淋巴结转移的风险比较

Comparison of Clinicopathological Characteristics and Risk of Lymph Node Metastasis After Endoscopic Submucosal Dissection in Young and Middle-Aged and Elderly Patients with Early Gastric Cancer

目的比较中青年与老年早期胃癌(EGC)患者临床病理特征及内镜黏膜下剥离术(ESD)后淋巴结转移(LNM)的风险。方法收集2017年9月至2020年9月于河南省人民医院消化内镜中心接受ESD治疗并且经术后病理证实为EGC的211例患者的临床资料。按年龄将患者分为中青年组与老年组。比较两组临床病理特征并分析ESD术后患者LNM风险分布情况。结果在211例患者中,男162例(76.8%),女49例(23.2%),男女患者比例为3.3∶1,患病年龄集中在50~70岁。中青年组82例(38.9%),老年组129例(61.1%)。老年组性别、肿瘤位置、内镜下分型、浸润深度、组织分化类型、淋巴管浸润、静脉浸润、溃疡以及切缘情况与中青年组比较,差异无统计学意义(P>0.05)。老年组肿瘤直径与中青年组比较,差异有统计学意义(P<0.05)。根据eCura评分系统提示得到,两组均以低危患者较多。两组LNM风险分类比较,差异无统计学意义(P>0.05)。结论EGC好发于男性,年龄集中于50~70岁。老年EGC患者的肿瘤直径较中青年患者短,但两者LNM风险类似。

Objective To compare the clinicopathological characteristics and risk of lymph node metastasis(LNM)after endoscopic submucosal dissection(ESD)in young and middle-aged and elderly patients with early gastric cancer(EGC).Methods The clinical data of 211 patients who underwent ESD treatment at the Digestive Endoscopy Center of Henan Provincial People’s Hospital from September 2017 to September 2020 and were confirmed to be EGC by postoperative pathology were collected.The patients were divided into young and middle-aged group and elderly group by age.The clinicopathological characteristics of the two groups were compared and the risk distribution of LNM in patients after ESD was analyzed.Results Among 211 patients,there were 162 males(76.8%)and 49 females(23.2%).The ratio of male to female patients was 3.3 to 1.The age of the disease was concentrated in 50 to 70 years.There were 82 cases(38.9%)in young and middle-aged group and 129 cases(61.1%)in elderly group.The gender,location of tumor,endoscopic classification,depth of invasion,type of tissue differentiation,lymphatic infiltration,venous infiltration,ulcer and resection margins in elderly group were not statistical different from those in young and middle-aged group(P>0.05).The diameter of tumor in elderly group was compared with that in young and middle-aged group,with a statistical difference(P<0.05).According to the eCura scoring system,there were more low-risk patients in both groups.There was no statistical difference between the two groups of LNM risk classification(P>0.05).Conclusion EGC is more common in males,mostly aged between 50 and 70 years.The diameter of tumor in elderly EGC patients is shorter than that in young and middle-aged patients,but the risk of LNM is similar between the two types of patients.