同时性多发早期胃癌的临床特征及主次病灶之间的相关性分析*

Clinical characteristics of synchronous multiple early gastric cancer and correlation analysis between main and minor lesions*

摘要:

摘要：目的??探究同时性多发早期胃癌（SMEGC）的临床病理学特征以及主要病灶与次要病灶之间的相关性。方法 回顾性研究2016年1月－2019年4月在宁波市医疗中心李惠利医院经内镜黏膜下剥离术（ESD）治疗的305例早期胃癌患者的病历资料，收集患者的年龄、性别、肿瘤宏观形态、位置、直径、有无溃疡、表面有无发红、组织病理学类型和浸润深度等情况，分析SMEGC与单发早期胃癌的临床病理特征的差异以及主次病灶之间的相关性。结果 所有早期胃癌患者中，25例（8.2%）为SMEGC，280例（91.8%）为单发早期胃癌；SMEGC患者年龄>?60岁的比例（76.0%，19/25）高于单发早期胃癌（52.9%，148/280）；肿瘤直径≤2.00?cm的比例（68.0%，17/25）高于单发早期胃癌（46.1%，129/280），差异有统计学意义（P??0.05）。SMEGC主要病灶直径明显大于次要病灶，差异有统计学意义（P??0.05）。结论 SMEGC的预测危险因素是60岁以上的患者、直径不超过2.00 cm的肿瘤，主次病灶的临床病理特征相似，包含这些因素的早期胃癌患者应该进行更仔细的内镜检查，注意主次病灶间的相关性，提高SMEGC的检出率。

Abstract:

Abstract: Objective?To explore the clinicopathological characteristics of synchronous multiple early gastric cancer (SMEGC) and correlation analysis between main and minor lesions.?Methods?The medical records of 305 patients with early gastric cancer treated with endoscopic submucosal dissection (ESD) from January 2016 to April 2019 were analyzed retrospectively. The data of patients including age, gender, tumor macroscopic morphology, tumor location, diameter, presence of ulcer, redness of the surface, histological type, depth of invasion were collected. The clinicopathological characteristics of SMEGC, single early gastric cancer and correlation between main and minor lesions were analyzed.?Results?Among the 305 patients with early gastric cancer, 25 cases (8.2%) were SMEGC, 280 cases (91.8%) were single early gastric cancer. The proportion of SMEGC patients with age >?60 years (76.0%, 19/25) is higher than that with single early gastric cancer (52.9%, 148/280), and the proportion of SMEGC patients with tumor diameter ≤?2.00 cm (68.0%, 17/25) was higher than that of single early gastric cancer (46.1%, 129/280), the difference was statistically significant (P??0.05). The diameter of main lesions was significantly larger than that of minor lesions, the difference was statistically significant (P??0.05).?Conclusion?The prediction risk factors for SMEGC are patients over 60 years old and tumors less than 2.00 cm in diameter, the clinicopathological characteristics of main and minor lesions are similar, patients with early gastric cancer with these factors should accept more careful endoscopic examination. Pay attention to the correlation between main and minor lesions and improve the detection rate of SMEGC.