文章摘要
朱旭东,党旖旎,孔子昊,王 云,张国新.同时性多发早期胃癌的相关风险因素和临床病理特征[J].南京医科大学学报,2020,(9):1319~1324
同时性多发早期胃癌的相关风险因素和临床病理特征
Risk factors and clinicopathologic characteristics of synchronous multiple early gastric neoplasms
投稿时间:2020-03-30  
DOI:10.7655/NYDXBNS20200913
中文关键词: 同时性多发早期胃癌  高级别上皮内瘤变  风险因素  临床病理特征
英文关键词: synchronous multiple neoplasms  high grade intraepithelial neoplasia  risk factor  clinicopathologic characteristics
基金项目:国家自然科学基金面上项目(81770561)
作者单位
朱旭东 南京医科大学第一附属医院消化内科江苏 南京 210029 
党旖旎 南京医科大学第一附属医院消化内科江苏 南京 210029 
孔子昊 南京医科大学第一附属医院消化内科江苏 南京 210029 
王 云 南京医科大学第一附属医院消化内科江苏 南京 210029 
张国新 南京医科大学第一附属医院消化内科江苏 南京 210029 
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中文摘要:
      目的:分析总结同时性多发早期胃癌(synchronous multiple early gastric cancer,SMEGC)的相关风险因素和临床病理特征,帮助临床医师提高SMEGC的检出率。方法:回顾性收集2014年6月—2018年12月于南京医科大学第一附属医院诊断并接受内镜下黏膜剥离术(endoscopic mucosal dissection,ESD)治疗的早期胃癌(early gastric cancer,EGC)或高级别上皮内瘤变(high?grade intraepithelial neoplasia,HGIN)患者数据,共517例纳入研究。结果:35例(6.8%)被诊断为SMEGC。发现男性(P=0.028)、慢性萎缩性胃炎(P=0.024)和中重度肠化生(P=0.048)是SMEGC的独立危险因素。而且,SMEGC患者和单发肿瘤患者的生存率没有显著差异(P=0.976)。 此外,根据Moertel标准区别主、副病灶,主病灶和副病灶的大小呈显著正相关(r=0.779,P=0.001)。主、副病灶内镜下大体分型的一致率为51%(P=0.02)。 结论:针对有慢性萎缩性胃炎或中重度肠化生的男性SMEGC高风险人群,内窥镜医师需要更加细致地检查,并对主、副病灶间的联系有充分认识,才能避免遗漏SMEGC病灶。
英文摘要:
      Objective:This study aims to investigated and summarized the risk factors and clinicopathological characteristics of synchronous multiple early gastric cancer(SMEGC) to help clinicians improve the detection rate of SMEGC. Methods:Medical records of patients with early gastric cancer (EGC) or high?grade intraepithelial neoplasia (HGIN) wete retrospectively reviewed form June 2014 to December 2018. In total,517 patients were included. Results:SMEGC was diagnosed in 35 patients(6.8%). Male (P=0.028),chronic atrophy gastritis(P=0.024),and moderate to severe intestinal metaplasia(P=0.048) were independent risk factors for the SMEGC. Also,there were no significant differences in survival rates between patients with SMEGC and patients with single neoplasm(P=0.976). Further,main or minor lesions were defined according to Moertel standard. Main and minor lesions showed significant positive correlation in size(r=0.779,P=0.001). Macroscopic types were identical in 51%(P=0.02)between main lesions and minor lesions. Conclusion:Therefore,the endoscopic physicians need a more meticulous endoscopic examination and find the possibility of SMEGC considering characteristics of main and minor lesions.
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