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对T1结直肠癌内镜切除的垂直边缘参与的调查

Yuki Kano¹, Yoichi Yamamoto¹, Hiroaki Ikematsu¹

¹Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan.

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society

|August 12, 2023

概括

带有不完整垂直边缘的粘膜下侵袭性结直肠癌 (CRC) 的内镜切除 (ER) 具有显著的残留瘤和淋巴结转移的风险. 在这些情况下,实现垂直边缘负切除对于成功的治疗结果至关重要.

科学领域:

胃肠病学胃肠病学
手术瘤学手术瘤学
病理学病理学病理学

背景情况:

下侵袭性结直肠癌 (CRC) 需要对淋巴结转移进行仔细的病理评估,以指导切除策略.
对于下侵袭性CRC的内切除 (ER) 的结果,特别是关于垂直边缘状态的结果,缺乏广泛的大规模研究.
了解ER中的垂直边缘参与对于预测治疗后果至关重要.

研究的目的:

为了评估内镜切除 (ER) 对下侵袭性结直肠癌 (CRC) 的结果,重点关注垂直边缘状态.
调查ER期间垂直边缘干涉与残留瘤和淋巴结转移的风险之间的关联.
探索垂直边缘状态在下侵袭性CRC的管理中的临床影响.

主要方法:

在2008年至2020年期间,对395例用ER治疗的下侵入性CRC病例进行了回顾性分析.
在垂直不完整ER患者和垂直边缘负ER患者之间的残留瘤和淋巴结转移率的比较.
在ER后接受了额外手术的患者的结局评估.

主要成果:

在下侵入性CRC中,垂直不完整ER的比率为21.5%,正边缘为12.2%,不清楚边缘为9.3%.
垂直不完整ER患者的残留瘤 (P=0.001) 和淋巴结转移率 (P=0.029) 显着更高,与那些接受了额外手术的垂直边缘负组相比.
不完整的垂直边缘切除与复发和转移的实质性风险有关.

结论:

在下侵袭性CRC中,垂直不完整的ER与残留瘤的显著风险有关.
在ER期间不完整的垂直边缘对于下CRC与更高的淋巴结转移发病率有关.
实现垂直边缘负切除对于改善粘膜下侵袭性结直肠癌内镜切除结果至关重要.

关键词:

结肠直肠癌是什么意思淋巴结解剖淋巴结解剖淋巴结解剖淋巴结转移是淋巴结的转移.这是残留的瘤残留.回顾性研究是回顾性研究.

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