Risk factors of postoperative noncurative resection for early gastroesophageal junction cancer after endoscopic submucosal dissection
HUANG Xiaojie1, LIN Xiaolu2, LIANG Wei2, LIN Ying2, CHENG Hui2, YANG Shijie2,LIN Haining2, ZHENG Weiping1, DENG Wanyin2#br#
(1. College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou Fujian 350122; 2. Digestive Endoscopy Center, Fujian Provincial Hospital, Fuzhou Fujian 350001, China)
Abstract:[Abstract]Objective: To investigate the risk factors of noncurative resection of earlystage gastroesophageal junction (GEJ) cancer after endoscopic submucosal dissection (ESD). Methods: A total of 114 patients with early GEJ cancer who underwent ESD in the Digestive Endoscopy Center of Fujian Provincial Hospital from October 2016 to September 2020 were selected and divided into the curative resection group and the noncurative resection group, according to the postoperative pathological examination results. The gender, age, tumor diameter, tumor morphology, pathological type, depth of invasion and whether there was ulcer, etc. were compared between the two groups. Logistic regression analysis was used to figure out the related factors that may be associated with non-curative resection. Spearman correlation analysis was performed between the number of independent risk factors and the rate of noncurative resection. Results: There were no significant differences between the two groups in terms of gender, age, lesion shape, lesion location, deep cystic gastritis and background mucositis(all P>0.05), while tumor diameter, submucosal infiltration, ulcer, pathological type and submucosal fibrosis were signifcantly different(all P<0.05). Logistic analysis showed that tumor diameter(>2 cm), submucosal infiltration, ulcer and undifferentiated carcinoma are independent risk factors for noncurative resection of early GEJ cancer. The number of independent risk factors was correlated with the incidence of postoperative noncurative resection (rs=0.492, P<0.01), the more risk factors, the higher non-curative resection rate. Conclusion:Tumor diameter (>2 cm), submucosal infiltration, ulcer and undifferentiated carcinoma are independent risk factors for noncurative resection after ESD for earlystage GEJ cancer; the greater the number of risk factors, the higher the propotion of noncurative resection.
黄小杰,林晓露,梁玮,等. 早期胃食管结合部癌行内镜黏膜下剥离术后非治愈切除的危险因素分析[J]. 江苏大学学报:医学版, 2022, 22(04): 350-354.
HUANG Xiaojie1, LIN Xiaolu2, LIANG Wei2, LIN Ying2, CHENG Hui2, YANG Shijie2,LIN Haining2, ZHENG Weiping1, DENG Wanyin2. Risk factors of postoperative noncurative resection for early gastroesophageal junction cancer after endoscopic submucosal dissection. Journal of Jiangsu University(Medicine Edition), 2022, 22(04): 350-354.
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