内镜剥离术治疗早期胃癌及高级别上皮内瘤变的远期转归分析

Long-term outcome of endoscopic dissection in the treatment of early gastric cancer and high-grade intraepithelial neoplasia

目的分析内镜剥离术治疗早期胃癌及高级别上皮内瘤变的远期效果。方法回顾性分析2014年5月至2016年5月68例早期胃癌及高级别上皮内瘤变患者的临床资料,根据手术方式不同,将采用内镜剥离术治疗的34例患者纳入内镜组,采用开腹手术治疗的34例患者纳入开腹组。采用SPSS 23.0软件进行处理,生活质量(GQOLI-74)评分以(x±s)表示,采用独立t检验;治疗效果、并发症发生率及肿瘤复发率采用χ^(2)检验;生存率采用Kaplan-meier法检验。P<0.05差异有统计学意义。结果两组胃癌治愈率、一次整块切除率、一次完整切除率、并发症发生率比较,差异无统计学意义(P>0.05);两组患者术后1年、3年、5年生存率比较,5年内生存率均为94.1%,差异无统计学意义(P>0.05);内镜组术后GQOLI-74评分高于开腹组(P<0.05)。结论内镜剥离术与外科开腹手术治疗胃癌早期及高级别上皮内瘤变疗效及安全性相似,但前者更利于生活质量改善,两者5年内生存率相当。

Objective To analyze the long-term outcome of endoscopic dissection in the treatment of early gastric cancer and high-grade intraepithelial neoplasia.Methods The clinical data of 68 patients with early gastric cancer and high-grade intraepithelial neoplasia from May 2014 to May 2016 were analyzed retrospectively.34 patients were divided into the endoscopy group who underwent endoscopic dissection,while 34 patients were divided into the laparotomy group who received laparotomy.Statistical analysis were performed by using SPSS23.0 software.The data of quality of life(GQOLI-74)score was expressed as,and were examined by using t test;The incidence of complication and tumor recurrence were examined by usingχ^(2) test;The survival were analyzed by using Kaplan-meier Law test.A P value of<0.05 was considered as statistically significant difference.Results There were no significant difference between the endoscopy and the laparotomy group in terms of the cure rate of gastric cancer,the rate of en bloc resection,the rate of complete resection,and the incidence of complications(P>0.05);Comparing the 1-year,3-year,and 5-year survival,5-year survival of 94.1%were achieved in both two groups(P>0.05);Compared with the laparotomy group,higher GQOLI-74 score was observed in the endoscopy group(P<0.05).Conclusion The clinical outcome including the 5-year survival of the endoscopic dissection are similar to the laparotomy in the treatment of early gastric cancer and high-grade intraepithelial neoplasia,however the former has obvious advantage in improving the quality of life.