影响早期胃癌内镜治愈性切除的相关因素研究

摘要

Objective To study the relative risk factors of endoscopic submucosal dissection (ESD) for early gastric cancer.Methods The clinic data of 50 cases of early gastric cancer treated by ESD were analyzed retrospectively .Tumor site, tumor size,macroscopic type,histological grade,tumor infiltration,lymph node metastases and vascular invasion were analyzed . Results The complete resection rate and the histologically complete resection rate was 98.75%,1-,3-year survival rates were 97.5% and 92.5%.Logistic analysis indicated that histological type ,tumor infiltration,lymph node metastases and vascular inva -sion were significant prognostic factors regarding overall survival (P <0.05),but tumor site and macroscopic type were not signifi -cant prognostic factors(P >0.05).Conclusion Early gastric cancer patients with lower histological grade ,deeper infiltration and lymph node metastases have poor prognosis ,they should receive comprehensive therapy after ESD and strict follow -up.%目的：探讨影响早期胃癌（early gastric cancer，EGC）内镜治愈性切除的相关因素。方法回顾性分析行内镜下黏膜下剥离术的80例早期胃癌患者的临床资料，统计分析肿瘤部位、肿瘤大小、大体类型、分化程度、肿瘤浸润深度、脉管瘤栓和区域淋巴结转移情况。结果80例早期胃癌癌灶一次性完整切除率及组织学完整治愈率为98．75％，患者术后1、3年生存率分别为97．5％、92．5％。 Logistic 回归分析结果显示术后患者预后与肿瘤部位、大体类型无关（P ＞0．05），与分化程度、浸润深度及淋巴结转移有显著相关性（P ＜0．05）。结论低分化、组织类型、浸润深度深及伴有区域淋巴结转移的早期胃癌患者预后较差，临床上要高度关注这些因素来评估预后，伴有高危险因素的患者术后应接受综合治疗并严密随访。