长期和第二次复发后治疗ESD的同步多重早期胃瘤:一个单中心队列研究
Jing Wang1, Meichen Liu1, Biao Fan2
1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Endoscopy Center, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
Surgical endoscopy
|February 27, 2026
概括
同步多重早期胃瘤 (SM-EGN) 患者在内镜下粘膜切割 (ESD) 后面临更高的复发风险. 对这些患者来说,终身监测至关重要,因为第一次和第二次复发的风险增加.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 内視鏡外科手術 內視鏡外科手術
背景情况:
- 同步多重早期胃瘤 (SM-EGN) 的检测正在随着先进的内镜成像增加.
- 对于SM-EGN,在内镜下膜剖析 (ESD) 后的长期复发模式尚不清楚,特别是对于第二次复发.
研究的目的:
- 为了比较SM-EGN患者治疗ESD后的复发动态,与单独的早期胃瘤相比.
- 在早期胃瘤患者中确定复发和第二次复发的预测因子.
主要方法:
- 对987名因早期胃瘤而接受ESD治疗的患者 (2012-2024) 的回顾性分析.
- 在91个SM-EGN和896个治疗切除的单独病例和>=1年的随访期间,对临床结果和复发模式的比较.
- 后勤回归和卡普兰-梅尔分析以确定预测因素并评估长期结果.
主要成果:
- 与单个病例相比,SM-EGN患者的复发率 (11.7%与4.8%) 和第二次复发率 (3.9%与0.7%) 较高.
- SM-EGN是复发的独立预测因子 (OR 2.162,p=0.048).
- 对于第一次和第二次复发,SM-EGN患者的同步和超时复发率更高,无病生存期 (DFS) 更短.
结论:
- SM-EGN与ESD后持续较高的复发风险有关,反映了现场癌症化.
- 在第二次复发队列中没有发现显著的生存差异,这可能是由于密集监测.
- 建议对SM-EGN患者进行终身,风险适应的监测.
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