早期胃癌内镜黏膜下剥离术C-2级切除的风险因素

Risk Factors for Endoscopic Submucosal Dissection C-2 Resection in Early Gastric Cancer

目的:明确早期胃癌(Early gastric cancer, EGC)经内镜黏膜下剥离术(Endoscopic submucosal dissection, ESD)内镜治愈度(Endoscopic curability, eCura) C-2切除的风险因素。方法:回顾性收集2017年10月至2021年9月于青岛大学附属医院经ESD治疗的658个EGC病灶,根据病灶的治愈情况分为eCura C-2 ESD组与非eCura C-2 ESD组,分析两组的临床及病理特征。结果:65 (9.9%)个病灶经ESD eCura C-2切除。单因素分析提示男性患者,吸烟史,饮酒史,癌胚抗原 】3.4 g/L,多发EGC,肿瘤位于贲门、胃底或胃体,未分化型组织学,混合组织学,以及病灶直径 】20 mm均与ESD eCura C-2切除相关(P均 20 mm (OR = 4.918, P 【0.001),多发EGC (OR = 2.871, P = 0.026),以及吸烟史(OR = 2.004, P = 0.036)。结论:具有上述ESD eCura C-2切除独立风险因素的EGC病灶应更加彻底地剥离。

Objective: To clarify the risk factors for endoscopic curability (eCura) C-2 endoscopic submucosal dissection (ESD) in early gastric cancer (EGC). Methods: 658 EGCs who underwent ESD between October 2017 and September 2021 at the Affiliated Hospital of Qingdao University were retrospectively collected. All enrolled EGCs were divided into eCura C-2 ESD group and non-eCura C-2 ESD group according to the curability. The clinicopathological characteristics of the two groups were analyzed. Results: 65 (9.9%) lesions underwent eCura C-2 ESD. Univariate analysis revealed that male sex, smoking and drinking history, carcinoembryonic antigen level >3.4 g/L, multiple EGCs, tumors located in cardia, fundus or corpora, undifferentiated histology, mixed histology and lesion size >20 mm were associated with eCura C-2 ESD (All the above factors, P 20 mm (OR = 4.918, P <0.001), multiple EGCs (OR = 2.871, P = 0.026) and smoking history (OR = 2.004, P = 0.036) were independent risk factors for eCura C-2 ESD. Conclusions: EGCs with independent risk factors for eCura C-2 ESD described above should be more thoroughly resected.