内镜下黏膜剥离术治疗未分化型早期胃癌患者的效果

Effects of endoscopic mucosal dissection in treatment of patients with early gastric cancer of undifferentiated type

目的:观察内镜下黏膜剥离术(ESD)治疗未分化型早期胃癌患者的效果。方法:回顾性分析2021年1月至2022年1月该院收治的100例未分化型早期胃癌患者的临床资料,根据手术方法不同将其分为对照组和观察组各50例。对照组行腹腔镜胃癌根治术治疗,观察组行ESD治疗。比较两组整块切除率,治愈性切除率,预后指标(住院时间、肛门排气时间、首次进食时间)水平,手术前后肿瘤标志物[癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)]水平,并发症发生率,以及1年复发率。结果:观察组整块切除率高于对照组,治愈性切除率低于对照组,差异均有统计学意义(P<0.05);观察组住院时间、肛门排气时间、首次进食时间均短于对照组,差异有统计学意义(P<0.05);术后1周,两组CEA、CA19-9、CA125水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为12.00%(6/50),低于对照组的36.00%(18/50),差异有统计学意义(P<0.05);两组1年复发率比较,差异无统计学意义(P>0.05)。结论:ESD治疗未分化型早期胃癌患者可提高整块切除率,以及降低预后指标水平、肿瘤标志物水平和并发症发生率的效果优于腹腔镜胃癌根治术,但治愈性切除率较低。

Objective:To observe effects of endoscopic mucosal dissection(ESD)in treatment of patients with early gastric cancer of undifferentiated type.Methods:The clinical data of 100 patients with early gastric cancer of undifferentiated type admitted to this hospital from January 2021 to January 2022 were retrospectively analyzed.According to different surgical methods,they were divided into control group and observation group,50 cases in each group.The control group was treated with laparoscopic radical gastrectomy,while the observation group was treated with ESD.The en bloc resection rate and the curative resection rate,the prognostic indicators(hospitalization time,anal exhaust time,first feeding time)levels,the tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 125(CA125)]levels before and after the surgery,the incidence of complications,and the 1-year recurrence rate were compared between the two groups.Results:The en bloc resection rate of the observation group was higher than that of the control group,the curative resection rate was lower than that of the control group,and the differences were statistically significant(P<0.05).The hospitalization time,the anal exhaust time and the first eating time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).1 week after the surgery,the levels of CEA,CA19-9 and CA125 in the two groups were lower than those before the surgery,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 12.00%(6/50),which was lower than 36.00%(18/50)in the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in the 1-year recurrence rate between the two groups(P>0.05).Conclusions:ESD treatment for the patients with early gastric cancer of undifferentiated type can improve the en bloc resection rate,and reduce the levels of prognostic indicators,tumor markers and the incidence of complications.It is superior to laparoscopic radical gastrectomy,but the curative resection rate is low.