| Objective: This article retrospectively analyzes the clinical and path ological data and postoperative follow-up data of patients with early gas tric cancer treated by endoscopic submucosal dissection,in order to eval uate the effectiveness and safety of ESD treatment.Methods:1.Collect the clinicopathological data of EGC patients who receive d ESD treatment from January 2017 to December 2019 at the Endoscop ic Center of the Second Hospital of Hebei Medical University.Accordin g to the relevant data,it was divided into curative resection group and non-curable resection group.The gender,age,diameter of the lesion,pat hological changes,depth of invasion and other data of each group were compared and analyzed to study the risk factors of non-curative resecti on of ESD.2.The follow-up review and survival of patients were followed up by telephone,especially in patients with non-curative resection.Results:1.Among the 99 patients included,the male to female ratio was 85/14(85.9% / 14.1%).After the age of 40,the number of cases increas ed significantly,and reached a peak around the age of 65.The diamete r of the lesion was 2.32 ± 1.73 cm.2.Among the lesions,70 cases(70.7%)were located in the upper 1/3,13 cases(13.1%)in the middle 1/3,and 16 cases(16.2%)in the l ower 1/3.3.Postoperative pathological results showed that 2 cases(2.0%)ha d LGIN,2(2.0%)HGIN,69(69.8%)differentiated carcinomas,13(13.1%)undifferentiated carcinomas,and 13(13.1%)mixed histological typecarcinomas.The invasive depth reached 65 cases(65.6%)of the mucos al layer,17 cases(17.2%)of the submucosa <500 ?m,and 17 cases(17.2%)of the submucosa ?500 ?m.En bloc resection 99 cases(100%),complete resection 79 cases(79.8%),and curative resection 71 cases(71.7%).4.There were statistically significant differences in the diameter,hi stological type,and depth of invasion of the lesions between the curativ e resection group and the non-curative resection group(P <0.05).There was no statistical difference between gender,age,location,and ulcer.5.The median follow-up time was 15 months,and range was 2-31 months.In the e Cura C grade,8 patients underwent additional surgery,and 1 patient found local cancer residues and regional lymph node met astases.4 patients had recurrence.Three patients had synchronous recurr ence,two of which were curative resections;one who was a non-curativ e resection with a positive horizontal margin had metachronous recurren ce.Conclusions:1.The incidence of early gastric cancer in male is significantly hig her than that in female,and the incidence rate is significantly increased over the age of 40.The peak incidence is around 65 years old,and th e lesions occur in the cardia frquently.2.Curative resection is related to lesion diameter,histological type,and depth of invasion,and has nothing to do with gender,age,and le sion location.It is suggested that the larger diameter of the lesion,histo logy with undifferentiated carcinoma,and submucosal invasion are high risk factors for non-curative resection.3.The en bloc resection rate of ESD is 100%,the complete resecti on rate is 79.8%,and the curative rate is 71.7%.Postoperative complica tions are more common with fever and bleeding,which are all treated e ffectively.It proves that ESD is a safe and effective method for the tre atment of EGC,but the selection of indications should be careful.4.Non-curative resection patients combined with e Cura system and e Cura scoring system can be better evaluated the risk of recurrence and lymph node metastasis,so that patients can be managed hierarchically and provided more suitable individualized treatment strategies. |
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