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中华腔镜外科杂志(电子版) ›› 2021, Vol. 14 ›› Issue (02) : 104 -108. doi: 10.3877/cma.j.issn.1674-6899.2021.02.008

论著

胃低级别瘤变内镜下氩离子凝固术后局部复发的影响因素
李宝1, 柴宁莉1, 汤小伟1, 王楠钧1, 李隆松1, 令狐恩强1,()   
  1. 1. 100853 北京,解放军总医院第一医学中心消化内科医学部
  • 收稿日期:2021-01-17 出版日期:2021-04-30
  • 通信作者: 令狐恩强
  • 基金资助:
    国家重点研发计划(2016YFC1303601)

Risk factors of local recurrence of gastric low-grade intraepithelial neoplasia after endoscopic argon plasma coagulation

Bao Li1, Ningli Chai1, Xiaowei Tang1, Nanjun Wang1, Longsong Li1, Enqiang Linghu1,()   

  1. 1. Department of Gastroenterology and Hepatology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
  • Received:2021-01-17 Published:2021-04-30
  • Corresponding author: Enqiang Linghu
引用本文:

李宝, 柴宁莉, 汤小伟, 王楠钧, 李隆松, 令狐恩强. 胃低级别瘤变内镜下氩离子凝固术后局部复发的影响因素[J/OL]. 中华腔镜外科杂志(电子版), 2021, 14(02): 104-108.

Bao Li, Ningli Chai, Xiaowei Tang, Nanjun Wang, Longsong Li, Enqiang Linghu. Risk factors of local recurrence of gastric low-grade intraepithelial neoplasia after endoscopic argon plasma coagulation[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(02): 104-108.

目的

探讨胃低级别上皮内瘤变(low grade intraepithelial neoplasia, LGIN)内镜下氩离子凝固术(argon plasma coagulation, APC)治疗后局部复发的影响因素。

方法

回顾性收集2013年4月至2020年9月,在解放军总医院第一医学中心消化内镜中心因术前活检病理结果证实为胃LGIN行APC治疗的111例病例资料,运用单因素和多因素Cox回归分析方法分析局部复发的影响因素。

结果

在随访时间1.0~83.0个月(中位时间19.0个月)中,APC术后总局部复发率为19.8%(22/111),多因素Cox回归分析显示,病变>2 cm(HR=4.16,95%CI:1.62~10.68,P=0.003)是局部复发的独立危险因素。

结论

APC治疗胃LGIN术后局部复发不容忽视,若病变>2 cm,建议术后更严谨的内镜检查随访,仔细评估病变周围黏膜情况,警惕局部复发的出现。

Objective

To investigate the risk factors of local recurrence of gastric low-grade intraepithelial neoplasia(LGIN) after endoscopic argon plasma coagulation(APC).

Methods

A retrospectively study was performed on the the data of 111 lesions who preoperative biopsy pathology confirmed gastric LGIN and underwent endoscopic APC from Apr. 2013 to Sep. 2020 in the Chinese PLA General Hospital. Univariate and multivariate Cox regression analysis were performed to identify the risk factors for local recurrent.

Results

The follow-up time ranged from 1 to 83 months, with median time of 19 months. Among the 111 lesions, the total incidence of local recurrence was 19.8% (22/111). The multivariate regression analysis showed that lesion size>2 cm(HR=4.16, 95%CI: 1.62-10.68, P=0.003)was the independent risk factor of local recurrence.

Conclusions

Local recurrence cannot be ignored for gastric LGIN after endoscopic APC. For lesion size>2 cm should be alert to postoperative local recurrence, and more attention should be paid to the mucosa around the lesions during strict endoscopic follow-up.

表1 胃低级别上皮内瘤变患者行氩离子凝固术治疗的基线资料
表2 胃LGIN患者111例中22例局部复发情况
表3 胃低级别上皮内瘤变患者行APC治疗局部复发单因素分析
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