| ObjectiveTo investigate the influence factors of endoscopic complete resection for early gastric cancer,and to provide suggestions for improving the resection rate of early gastric cancer.MethodsThe data of 112 patients who accepted endoscopic and pathological examinations were performed in the Department of Gastroenterology,Tai'an Central Hospital,in January 2015.1-2016.12.They were all treated with endoscopy.According to the age,gender and lesion size,location,endoscopic morphology,whether accompanied by ulceration,pathological type,depth of invasion,preoperative precision evaluation and other aspects of comparative analysis.To investigate the influence factors of endoscopic resection for early gastric cancer.resultsA total of 112 patients were included in the study,all of these cases were single tumor,105 cases underwent ESD resection,accounting for 93.8%,EMR resection was performed in 7 cases,6.2%,Among them,108 cases were removed en bloc,96.4%,complete resection was performed in 108 cases,92.9%,non-complete resection was performed in 8 cases,Positive margin of 6 cases,and 4 cases were non-complete resection,unable to access these cases.2 cases of basal positive,and 1 patients underwent reoperation.1 cases of elderly patient,combined with other diseases,he gave up surgical treatment,continue endoscopic followup.Male patients with 72 people,the complete resection rate 91.7%,women 40 people,complete resection rate 95%,the sex ratio of 1.8:1,the comparison,the two groups had no statistical significance(P>0.05);Average age 61 years old(32-84),60 years old or less,50 cases,complete resection rate 94% and>60 years old,62 cases,complete resection rate of 91.9%,compared the two have no statistical significance(P>0.05);Lesions on average 2.3 cm in diameter,were 1 cm or less,34 cases,complete resection rate 100%,> 1.0 ~ 2.0 cm,42 cases,complete resection rate 92.9%,> 2.0 ~ 3.0 cm,28 cases,complete resection rate 92.9%,> 3 cm,8 cases,complete resection rate 62.5%,four groups of comparison,the first three groups is no statistical significance(P>0.05),> 3 cm complete resection rate was significantly lower than the previous three group,with statistical significance(P<0.05);Lesions located in 22 cases of gastric cardia,complete resection rate 90.9%,25 cases of gastric body,complete resection rate was 92%,the stomach Angle of 19 cases,complete resection rate 94.8%,46 cases of gastric antrum,complete resection rate 93.5%,four groups have no statistical significance(P>0.05);Endoscopic morphology O-type I 30 cases,complete resection rate 93.3%,O-II 71 cases,complete resection rate 93.0%,O-III in 11 cases,90.9% complete excision,three groups had no statistical significance(P>0.05);62.5% of 8 cases with ulcers,complete resection,postoperative endoscopic treatment base positive in 1 case,no ulcer of 104 cases,complete resection rate 95.2%,both comparison was statistically significant(P<0.05),with complete resection rate was significantly lower than no ulcer ulcer group group;High-grade intraepithelial neoplasia group 55 cases,complete resection rate 90.9%,50 cases of differentiated carcinoma,complete resection rate 98%,undifferentiated carcinoma 7 cases(both for the postoperative pathological diagnosis of undifferentiated type,5 cases of preoperative endoscopic biopsy and assessment for high-grade intraepithelial neoplasia,2 cases of endoscopic biopsy and evaluation of differentiated carcinoma),complete resection rate was 71.4%,the comparison group,undifferentiated type of complete resection rate is lower than the differentiation group(P<0.05),the other two is no statistical significance(P> 0.05);Mucosa carcinoma in 105 cases,complete resection rate 94.3%,submucosa infiltrating carcinoma cases 7 cases,complete resection rate 71.4%,comparing the two groups have statistical significance,submucous infiltration complete resection rate is lower than the mucosa carcinoma(P<0.05).By magnifying endoscopy combined with narrow band imaging endoscopy for suspicious lesions(ME-NBI)were carried out to evaluate endoscopic found lesions,ME-NBI evaluation accuracy is significantly higher than that of white light endoscopy(97.8%vs84.4%,P<0.05),The accuracy rate of white light endoscopy for differentiated and undiffere-ntiated carcinoma was 107 cases,95.5%.High grade intraepithelial neoplasia by ME-NBI were 98%(54/55)ConclusionThe tumor size was larger than 3.0cm,with low differentiation,ulcers,submucosal infiltration may be early influencing factors of complete resection of gastric cancer.Accurate preoperative gastroscopy,white light endoscopy combined with magnifying endoscopy with narrow band imaging,can effectively reduce the rate of increase of pathological differentiation boundary underestimated,type of early gastric cancer invasion depth and accuracy of judgment,is also actively on to improve the early gastric endoscopic complete resection plays a role. |
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