早期胃食管结合部癌内镜黏膜特征与肿瘤浸润深度的关系

Relationship Between the Endoscopic Mucosal Characteristics of Early Gastroesophageal Junction Carcinoma and the Depth of Tumor Invasion

目的 分析早期胃食管结合部癌内镜黏膜特征及其与肿瘤浸润深度的关系。方法 选取168例胃食管结合部癌患者为研究对象,外科手术治疗前均行胃镜检查,观察早期胃食管结合部癌内镜黏膜特征,采用单因素和多元Logistic回归分析早期胃食管结合部癌内镜黏膜特征与肿瘤浸润深度的关系。结果 168例胃食管结合部癌患者,发病部位以后壁常见、内镜下分型以凹陷型为主、浸润深度黏膜层占比略高,内镜黏膜发红且表面粗糙。黏膜层组年龄≥60岁、黏膜发红、表面粗糙、边缘隆起、高级别上皮瘤变占比明显高于黏膜下层组(P<0.05);Logistic回归分析提示年龄(≥60岁)、黏膜发红、表面粗糙、边缘隆起、组织学分型与肿瘤浸润深度密切相关(P<0.05)。结论 早期胃食管结合部癌有黏膜发红、黏膜表面粗糙、边缘隆起、高级别上皮瘤变的内镜黏膜特征患者,肿瘤深浸润的风险高,需重视具有此类胃镜黏膜特征患者的早期诊治。

Objective To analyze the endoscopic mucosal features of early gastroesophageal junction carcinoma,and their relationship with the depth of tumor invasion.Methods 168 patients with gastroesophageal junction carcinoma were selected.All patients underwent gastroscopy before surgical treatment.Endoscopic mucosal features of early gastroesophageal junction carcinoma were observed.Univariate analysis and multivariate logistic regression analysis were performed to analyze the relationship between endoscopic mucosal features of early gastroesophageal junction carcinoma and the depth of tumor invasion.Results Gastroesophageal junction carcinomas in the 168 patients were mainly located in the posterior wall.The main endoscopic type was depressed type,and the proportion of invading mucosal layer was slightly higher.The mucosa was red and the surface was rough under endoscope.The proportions of patients ≥60,patients with red mucosa,rough surface,raised border and high-grade epithelial tumors in the mucosal layer group were significantly higher than those in the submucosal group(P<0.05).Logistic regression analysis showed that age ≥60,red mucosa,rough surface,raised border and histological classification were related to the depth of tumor invasion(P<0.05).Conclusion The risk of deep tumor infiltration is high in patients with early gastroesophageal junction carcinoma and endoscopic mucosal characteristics of mucosal redness,rough mucosal surface,edge uplift and high-grade epithelial neoplasia.Attention should be paid to the early diagnosis and treatment of patients with such endoscopic mucosal characteristics.