目的：探讨急性非静脉曲张性上消化道出血（NVUGIB）患者胃镜检查时间与临床疗效的关系，为临床选择最佳胃镜检查时机提供理论依据。方法选择急性 NVUGIB 患者78例，根据入院后接受胃镜检查的不同时间段分为超早期组（即入院后＜8 h 内...目的：探讨急性非静脉曲张性上消化道出血（NVUGIB）患者胃镜检查时间与临床疗效的关系，为临床选择最佳胃镜检查时机提供理论依据。方法选择急性 NVUGIB 患者78例，根据入院后接受胃镜检查的不同时间段分为超早期组（即入院后＜8 h 内开始胃镜检查）、早期组（即入院后8～24 h 内行胃镜检查）、常规组（即入院后＞24～48 h 内行胃镜检查）。比较3组患者胃镜下出血检出率、活动性出血检出率、胃镜止血后再出血检出率及输血率、出血量、住院时间。结果本组患者内镜下治疗有效率71.8％（56／78）。3组患者出血检出率差异无统计学意义（P ＞0.05）；超早期、早期组患者活动性出血检出率高于常规组（P ＜0.05），但止血后再出血检出率、输血率低于常规组（P ＜0.05）。超早期、早期组患者出血量及住院时间均少于常规组（P ＜0.05）。结论超早期、早期胃镜检查对于急性 NVUGIB 患者具有较大诊断优势，尤其针对于活动性出血病灶诊断方面显著优于常规胃镜检查，故急性 NVUGIB 患者在进行急诊胃镜检查时应当尽量提早检测时间，于出血24 h 内是急诊胃镜诊治的最佳时间。展开更多
Endoscopic treatment,such as endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD),has been established as one of the treatment options for selected cases with early gastric cancer(EGC).Most stud...Endoscopic treatment,such as endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD),has been established as one of the treatment options for selected cases with early gastric cancer(EGC).Most studies on this topic have been carried out by researchers in Japan.Recently,the experience in EMR/ESD for EGC outside Japan is increasingly reported.In Korea,gastric cancer is the most common malignant disease,and the second leading cause of cancer death.Currently,EMR for EGC is widely performed in many centers in Korea.Early results with a shortterm follow-up period are very promising in Korea.Thecomplete resection rate of EMR was 37.8%-94.3%,and that of ESD was 77.4%-93.1%.In this review,we will provide an overview of the outcomes of endoscopic treatments in Korea.展开更多
The diagnosis of early gastric cancer(EGC) is of great interest because its endoscopic and surgical treatment presents the best chance for a cure.With technical development,endoscopic submucosal dissection(ESD) has be...The diagnosis of early gastric cancer(EGC) is of great interest because its endoscopic and surgical treatment presents the best chance for a cure.With technical development,endoscopic submucosal dissection(ESD) has been widely performed for the curative treatment of EGC in Korea.Multinational studies of ESD for EGC will be the next missions that overcome these limitations and global guidelines will be processed for ESD for EGC.展开更多
The early diagnosis of gastric cancer allows patients and physicians to pursue the option of endoscopic resection,which is significantly less invasive than conventional surgical resection.In Korea,the use of endoscopi...The early diagnosis of gastric cancer allows patients and physicians to pursue the option of endoscopic resection,which is significantly less invasive than conventional surgical resection.In Korea,the use of endoscopic submucosal dissection(ESD) has been increasing,and many reports on ESD have been published.In addition,Korean gastroenterologists from several hospitals performing ESD have conducted formal meetings to discuss useful information regarding ESD.Here,we discuss the Korean experience with ESD,including outcomes and prospects of endoscopic treatments.展开更多
Endoscopic mucosal resection （EMR） has been established as one of the treatment options for early gastric cancer （EGC）. However, there are many uncertain areas such as indications of EIR, best treatment methods, m...Endoscopic mucosal resection （EMR） has been established as one of the treatment options for early gastric cancer （EGC）. However, there are many uncertain areas such as indications of EIR, best treatment methods, management of complications and follow-up methods after the procedure. Host studies on this topic have been carried out by researchers in Japan. In Korea, gastric cancer is the most common malignant disease, and the second leading cause of cancer death. In these days, EIR for EGC is widely performed in many centers in Korea. In this review, we will provide an overview of the bechniques and outcomes of EIR in Korea.展开更多
AIM： To investigate endoscopic and clinicopathologic characteristics of early gastric cancer （EGC） according to microsatellite instability phenotype. METHODS： Data were retrospectively collected from a single tert...AIM： To investigate endoscopic and clinicopathologic characteristics of early gastric cancer （EGC） according to microsatellite instability phenotype. METHODS： Data were retrospectively collected from a single tertiary referral center. Of 981 EGC patients surgically treated between December 2003 and October 2007, 73 consecutive EGC patients with two or more microsatellite instability （MSI） mutation [high MSI （MSI-H）] and 146 consecutive EGC patients with one or no MSI mutation （non-MSI-H） were selected. The endoscopic and clinicopathologic features were compared between the MSI-H and non-MSI-H EGC groups.RESULTS： In terms of endoscopic characteristics, MSI-H EGCs more frequently presented with elevated pattern （OR 4.38, 95% Cl： 2.40-8.01, P 〈 0.001）, moderate- to-severe atrophy in the surrounding mucosa （OR 1.91, 95% CI： 1.05-3.47, P = 0.033）, antral location （OR 3.99, 95% CI： 2.12-7.52, P 〈 0.001） and synchronous le- sions, compared to non-MSI-H EGCs （OR 2.65, 95% CI： 1.16-6.07, P = 0.021）. Other significant clinicopatholog- ic characteristics of MSI-H EGC included predominance of female sex （OR 2.77, 95% CI： 1.53-4.99, P 〈 0.001）, older age （〉 70 years） （OR 3.30, 95% CI： 1.57-6.92, P = 0.002）, better histologic differentiation （OR 2.35, 95% Cl： 1.27-4.34, P = 0.007）, intestinal type by Lau- ren classification （OR 2.34, 95% CI： 1.15-4.76, P = 0.019）, absence of a signet ring cell component （OR 2.44, 95% CI： 1.02-5.86, P = 0.046）, presence of mu- cinous component （OR 5.06, 95% Cl： 1.27-20.17, P = 0.022）, moderate-to-severe lymphoid stromal reaction （OR 3.95, 95% CI： 1.59-9.80, P = 0.003）, and co-exist- ing underlying adenoma （OR 2.66, 95% CI： 1.43-4.95, P = 0.002）. CONCLUSION： MSI-H EGC is associated with unique endoscopic and clinicopathologic characteristics includ- ing frequent presentation in protruded type, co-exist- ing underlying adenoma, and synchronous lesions.展开更多
Objective The present study aims to identify the clinicopathologic factors predictive of lymph node metastasis(LNM) in poorly differentiated early gastric cancer(EGC) and to expand the possibility of using laparoscopi...Objective The present study aims to identify the clinicopathologic factors predictive of lymph node metastasis(LNM) in poorly differentiated early gastric cancer(EGC) and to expand the possibility of using laparoscopic surgery for the treatment of poorly differentiated EGC. Methods Data from 70 cases of poorly differentiated EGC treated with surgery were collected.The association between clinicopathologic factors and the presence of LNM was retrospectively analyzed by univariate and multivariate logistic regression analyses. Results Univariate analysis showed that tumor size,depth of invasion,and lymphatic vessel involvement(LVI) were the significant and independent risk factors for LNM(all P<0.05).The LNM rates were 6.9%,45.5%,and 60.0%,respectively.There was no LNM in 25 patients without the above three risk factors. Conclusions Laparoscopic surgery is a sufficient treatment for intramucosal poorly differentiated EGC if the tumor is less than or equal to 2.0 cm in size and when LVI is absent upon postoperative histological examination.展开更多
OBJECTIVE To discuss the effects of clinico-pathological features on lymph node metastasis （LNM） in undifferentiated EGC （early gastric cancer）, as well as identify the appropriate medical management. METHODS From...OBJECTIVE To discuss the effects of clinico-pathological features on lymph node metastasis （LNM） in undifferentiated EGC （early gastric cancer）, as well as identify the appropriate medical management. METHODS From January 1999 to June 2011, 352 patients were treated for undifferentiated EGC in our hospital. All patients had undergone gastrectomy with regional lymphadenectomy. We used univariate and multivariate associated with lymph node entiated EGC. analyses to determine the features metastasis in patients with undiffer- RESULTS Signet ring cell carcinoma （SRC） was more common in patients with undifferentiated EGC than other undifferentiated carcinoma （UDC）. SRC had a tendency to be confined to the mucosa, with a smaller size than other UDC. The incidence of LNM for SRC was lower than that for other UDC. Multivariate analysis showed that LNM was associated with the sex, tumor size, depth of invasion, lymphovascular invasion, and histological type. CONCLUSION Complete endoscopic resection is suitable for SRC- type intramucosal EGC, which is less than 2 cm in diameter without lymphovascular invasion in the postoperative histological examination.展开更多
Endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)techniques have reduced the need for surgery in early esophageal and gastric cancers and thus has lessened morbidity and mortality in these dis...Endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)techniques have reduced the need for surgery in early esophageal and gastric cancers and thus has lessened morbidity and mortality in these diseases.ESD is a relatively new technique in western countries and requires rigorous training to reproduce the proficiency of Asian countries,such as Korea and Japan,which have very high complete(en bloc)resection rates and low complication rates.EMR plays a valuable role in early esophageal cancers.ESD has shown better en bloc resection rates but it is easier to master and maintain proficiency in EMR;it also requires less procedural time.For early esophageal adenocarcinoma arising from Barrett’s,ESD and EMR techniques are usually combined with other ablative modalities,the most common being radiofrequency ablation because it has the largest dataset to prove its success.The EMR techniques have been used with some success in early gastric cancers but ESD is currently preferred for most of these lesions.ESD has the added advantage of resecting into the submucosa and thus allowing for endoscopic resection of more aggressive(deeper)early gastric cancer.展开更多
文摘目的：探讨急性非静脉曲张性上消化道出血（NVUGIB）患者胃镜检查时间与临床疗效的关系，为临床选择最佳胃镜检查时机提供理论依据。方法选择急性 NVUGIB 患者78例，根据入院后接受胃镜检查的不同时间段分为超早期组（即入院后＜8 h 内开始胃镜检查）、早期组（即入院后8～24 h 内行胃镜检查）、常规组（即入院后＞24～48 h 内行胃镜检查）。比较3组患者胃镜下出血检出率、活动性出血检出率、胃镜止血后再出血检出率及输血率、出血量、住院时间。结果本组患者内镜下治疗有效率71.8％（56／78）。3组患者出血检出率差异无统计学意义（P ＞0.05）；超早期、早期组患者活动性出血检出率高于常规组（P ＜0.05），但止血后再出血检出率、输血率低于常规组（P ＜0.05）。超早期、早期组患者出血量及住院时间均少于常规组（P ＜0.05）。结论超早期、早期胃镜检查对于急性 NVUGIB 患者具有较大诊断优势，尤其针对于活动性出血病灶诊断方面显著优于常规胃镜检查，故急性 NVUGIB 患者在进行急诊胃镜检查时应当尽量提早检测时间，于出血24 h 内是急诊胃镜诊治的最佳时间。
文摘Endoscopic treatment,such as endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD),has been established as one of the treatment options for selected cases with early gastric cancer(EGC).Most studies on this topic have been carried out by researchers in Japan.Recently,the experience in EMR/ESD for EGC outside Japan is increasingly reported.In Korea,gastric cancer is the most common malignant disease,and the second leading cause of cancer death.Currently,EMR for EGC is widely performed in many centers in Korea.Early results with a shortterm follow-up period are very promising in Korea.Thecomplete resection rate of EMR was 37.8%-94.3%,and that of ESD was 77.4%-93.1%.In this review,we will provide an overview of the outcomes of endoscopic treatments in Korea.
文摘The diagnosis of early gastric cancer(EGC) is of great interest because its endoscopic and surgical treatment presents the best chance for a cure.With technical development,endoscopic submucosal dissection(ESD) has been widely performed for the curative treatment of EGC in Korea.Multinational studies of ESD for EGC will be the next missions that overcome these limitations and global guidelines will be processed for ESD for EGC.
文摘The early diagnosis of gastric cancer allows patients and physicians to pursue the option of endoscopic resection,which is significantly less invasive than conventional surgical resection.In Korea,the use of endoscopic submucosal dissection(ESD) has been increasing,and many reports on ESD have been published.In addition,Korean gastroenterologists from several hospitals performing ESD have conducted formal meetings to discuss useful information regarding ESD.Here,we discuss the Korean experience with ESD,including outcomes and prospects of endoscopic treatments.
文摘Endoscopic mucosal resection （EMR） has been established as one of the treatment options for early gastric cancer （EGC）. However, there are many uncertain areas such as indications of EIR, best treatment methods, management of complications and follow-up methods after the procedure. Host studies on this topic have been carried out by researchers in Japan. In Korea, gastric cancer is the most common malignant disease, and the second leading cause of cancer death. In these days, EIR for EGC is widely performed in many centers in Korea. In this review, we will provide an overview of the bechniques and outcomes of EIR in Korea.
文摘AIM： To investigate endoscopic and clinicopathologic characteristics of early gastric cancer （EGC） according to microsatellite instability phenotype. METHODS： Data were retrospectively collected from a single tertiary referral center. Of 981 EGC patients surgically treated between December 2003 and October 2007, 73 consecutive EGC patients with two or more microsatellite instability （MSI） mutation [high MSI （MSI-H）] and 146 consecutive EGC patients with one or no MSI mutation （non-MSI-H） were selected. The endoscopic and clinicopathologic features were compared between the MSI-H and non-MSI-H EGC groups.RESULTS： In terms of endoscopic characteristics, MSI-H EGCs more frequently presented with elevated pattern （OR 4.38, 95% Cl： 2.40-8.01, P 〈 0.001）, moderate- to-severe atrophy in the surrounding mucosa （OR 1.91, 95% CI： 1.05-3.47, P = 0.033）, antral location （OR 3.99, 95% CI： 2.12-7.52, P 〈 0.001） and synchronous le- sions, compared to non-MSI-H EGCs （OR 2.65, 95% CI： 1.16-6.07, P = 0.021）. Other significant clinicopatholog- ic characteristics of MSI-H EGC included predominance of female sex （OR 2.77, 95% CI： 1.53-4.99, P 〈 0.001）, older age （〉 70 years） （OR 3.30, 95% CI： 1.57-6.92, P = 0.002）, better histologic differentiation （OR 2.35, 95% Cl： 1.27-4.34, P = 0.007）, intestinal type by Lau- ren classification （OR 2.34, 95% CI： 1.15-4.76, P = 0.019）, absence of a signet ring cell component （OR 2.44, 95% CI： 1.02-5.86, P = 0.046）, presence of mu- cinous component （OR 5.06, 95% Cl： 1.27-20.17, P = 0.022）, moderate-to-severe lymphoid stromal reaction （OR 3.95, 95% CI： 1.59-9.80, P = 0.003）, and co-exist- ing underlying adenoma （OR 2.66, 95% CI： 1.43-4.95, P = 0.002）. CONCLUSION： MSI-H EGC is associated with unique endoscopic and clinicopathologic characteristics includ- ing frequent presentation in protruded type, co-exist- ing underlying adenoma, and synchronous lesions.
基金supported by the Science Foundation of Xingtai City,China(No.20102025-2)
文摘Objective The present study aims to identify the clinicopathologic factors predictive of lymph node metastasis(LNM) in poorly differentiated early gastric cancer(EGC) and to expand the possibility of using laparoscopic surgery for the treatment of poorly differentiated EGC. Methods Data from 70 cases of poorly differentiated EGC treated with surgery were collected.The association between clinicopathologic factors and the presence of LNM was retrospectively analyzed by univariate and multivariate logistic regression analyses. Results Univariate analysis showed that tumor size,depth of invasion,and lymphatic vessel involvement(LVI) were the significant and independent risk factors for LNM(all P<0.05).The LNM rates were 6.9%,45.5%,and 60.0%,respectively.There was no LNM in 25 patients without the above three risk factors. Conclusions Laparoscopic surgery is a sufficient treatment for intramucosal poorly differentiated EGC if the tumor is less than or equal to 2.0 cm in size and when LVI is absent upon postoperative histological examination.
文摘OBJECTIVE To discuss the effects of clinico-pathological features on lymph node metastasis （LNM） in undifferentiated EGC （early gastric cancer）, as well as identify the appropriate medical management. METHODS From January 1999 to June 2011, 352 patients were treated for undifferentiated EGC in our hospital. All patients had undergone gastrectomy with regional lymphadenectomy. We used univariate and multivariate associated with lymph node entiated EGC. analyses to determine the features metastasis in patients with undiffer- RESULTS Signet ring cell carcinoma （SRC） was more common in patients with undifferentiated EGC than other undifferentiated carcinoma （UDC）. SRC had a tendency to be confined to the mucosa, with a smaller size than other UDC. The incidence of LNM for SRC was lower than that for other UDC. Multivariate analysis showed that LNM was associated with the sex, tumor size, depth of invasion, lymphovascular invasion, and histological type. CONCLUSION Complete endoscopic resection is suitable for SRC- type intramucosal EGC, which is less than 2 cm in diameter without lymphovascular invasion in the postoperative histological examination.
文摘Endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)techniques have reduced the need for surgery in early esophageal and gastric cancers and thus has lessened morbidity and mortality in these diseases.ESD is a relatively new technique in western countries and requires rigorous training to reproduce the proficiency of Asian countries,such as Korea and Japan,which have very high complete(en bloc)resection rates and low complication rates.EMR plays a valuable role in early esophageal cancers.ESD has shown better en bloc resection rates but it is easier to master and maintain proficiency in EMR;it also requires less procedural time.For early esophageal adenocarcinoma arising from Barrett’s,ESD and EMR techniques are usually combined with other ablative modalities,the most common being radiofrequency ablation because it has the largest dataset to prove its success.The EMR techniques have been used with some success in early gastric cancers but ESD is currently preferred for most of these lesions.ESD has the added advantage of resecting into the submucosa and thus allowing for endoscopic resection of more aggressive(deeper)early gastric cancer.
