Relevant risk factors for positive lateral margin after en bloc endoscopic submucosal dissection for early gastric adenocarcinoma
Relevant risk factors for positive lateral margin after en bloc endoscopic submucosal dissection for early gastric adenocarcinoma
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早期胃腺癌整体内镜黏膜下剥离术术后侧切缘阳性的相关危险因素
DOI：
10.1111/1751-2980.12342
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发表时间：
2016-04-01
影响因子：
3.5
通讯作者：
Chen, Xiao Yu
中科院分区：
文献类型：
--
作者：
Fu, Qing Yan;Cui, Yun;Chen, Xiao Yu
目的：方法：选取2009年1月至2015年3月因早期胃癌病变行内镜下黏膜下剥离术（ESD）的患者242例，分析早期胃腺癌整块切除术后阳性侧切缘（LM）的相关危险因素。结果：治愈率为82.2%，LM阳性率为12.4%。单因素分析显示LM阳性与肿瘤的位置（胃上1/3）、大小（> 3cm）、组织学改变、淋巴管浸润和浸润深度有关。此外，LM阳性者肿瘤复发或残留的发生率较高。多因素分析显示，肿瘤部位、肿瘤大小和组织学类型是LM阳性的独立危险因素。结论：LM阳性与胃上1/3、大于3cm的肿瘤和混合型癌密切相关。此外，阳性LM有复发或残留肿瘤的倾向。
OBJECTIVE: This study aimed to systematically assess the relevant risk factors of positive lateral margin (LM) after en bloc resection of early gastric adenocarcinoma.METHODS: A total of 242 patients who had undergone endoscopic submucosal dissection (ESD) due to early gastric lesions from January 2009 to March 2015 were included in the study. Clinicopathological features of the lesions and the risk factors related to positive LM were analyzed.RESULTS: The curative rate was 82.2% and positive LM was found in 12.4% of the lesions. Univariate analysis showed that positive LM was significantly associated with the tumor location (at the upper third of the stomach), size (>3 cm), histological findings, the presence of lymphovascular invasion and deeper invasion depth. Moreover, positive LM had a higher incidence of recurrent or residual tumors. A multivariate analysis showed that the location, tumor size and histological classification of tumors were independent risk factors for positive LM.CONCLUSIONS: Positive LM is closely related to the upper third of stomach, a tumor larger than 3 cm and a mixed-type carcinoma. Additionally, positive LM has a predilection for recurrent or residual tumors.