首页|经内镜下切除早期胃癌患者幽门螺旋杆菌治疗结局与内镜特点分析

经内镜下切除早期胃癌患者幽门螺旋杆菌治疗结局与内镜特点分析

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目的 研究经内镜下切除早期胃癌患者幽门螺旋杆菌(Hp)治疗结局与内镜特点分析。方法 选取2021年1月至2023年7月于南通大学第六附属医院、南通大学附属医院就诊,有Hp感染历史,并接受标准化H p根除疗程的8 2例早期胃癌患者作为研究对象。H p根除治疗后经碳13呼气试验检测结果为阴性的患者纳入Hp根除组(n=60),胃镜下快速尿素酶检测、Hp粪便抗原试验或碳13呼气试验结果为阳性的患者纳入Hp未根除组(n=22)。比较两组患者临床及内镜特征资料,靶向活检不确定胃癌的未确诊患病率。结果 两组在性别、年龄、萎缩程度方面比较,差异无统计学意义(P>0。05);两组在病灶位置、宏观类型、色调及肿瘤直径方面比较,差异有统计学意义(P<0。05)。其中,Hp根除组在胃下1/3的占比最高(53。33%),Hp未根除组在胃上1/3占比最高(63。64%);在宏观类型方面,Hp根除组凹陷类型的占比最高(65。00%),而Hp未根除组隆起类型的占比最高(59。09%);在色调方面,Hp根除组红色的占比最高(83。33%);Hp根除组肿瘤直径<20 mm的占比较高(76。67%),而Hp未根除组肿瘤直径≥20 mm的占比较高(72。73%)。预处理内镜期间,Hp根除组靶向活检不确定胃癌的未确诊患病率为28。33%(17/60),高于Hp未根除组的4。55%(1/22),差异有统计学意义(x2=4。019,P=0。045)。结论 Hp根除对早期胃癌诊断具有重要影响。
Analysis of Helicobacter pylori treatment outcomes and endoscopic characteristics after endoscopic resection in patients with early gastric cancer
Objective To study the treatment outcome and endoscopic characteristics of Helicobacter pylori(Hp)after endoscopic resection in the patients with early gastric cancer.Methods The 82 patients with early-stage gastric cancer who had Hp infection history and received the standardized Hp radical treatment in the Sixth Affiliated Hospital of Nantong University and the Affiliated Hospital of Nantong University from January 2021 to July 2023 served as the research subjects.The patients with carbon 13 breath test negative re-sults after Hp eradication treatment were included in the Hp eradication group(n=60),and the patients with positive results of rapid urease test,Hp fecal antigen test or carbon 13 breath test under gastroscopy were in-cluded in the Hp non-eradication group(n=22).The clinical and endoscopic characteristic data and the preva-lence rate of uncertain gastric cancer by targeted biopsy were compared between the two groups.Results There was no statistically significant difference in the gender,age and atrophy degree between the two groups(P>0.05).There were statistically significant differences in the lesion location,macroscopic type,color tone and tumor size between the two groups(P<0.05).Among them,the proportion of the lower 1/3 of stomach in the Hp eradication group was the highest(53.33%),while the proportion of the upper 3/1 of the stomach in the Hp non-eradication group was the highest(63.64%).In terms of macroscopic type,the proportion of depression type in the Hp eradication group was the highest(65.00%),while the proportion of uplift type in the Hp non-eradication group was the highest(59.09%).In terms of hue,the proportion of red in the Hp eradication group was the highest(83.33%).The proportion of tumor diameter<20 mm in the Hp eradication group was higher(76.67%),while the proportion of tumor diameter 20 mm in the Hp non-eradication group was higher(72.73%).During the pretreatment endoscopy period,the prevalence rate of un-diagnosed gastric cancer by targeted biopsy in the Hp eradication group was 28.33%(17/60),which was higher than 4.55%(1/22)in the Hp non-eradication group,and the difference was statistically significant(X2=4.019,P=0.045).Conclusion Hp eradication has an important influence on the diagnosis of early gas-tric cancer.

Helicobacter pyloriearly gastric cancerendoscopic submucosal dissectionendoscopic fea-turestreatment

刘国良、施育华、蒋丹斌、刘燕华

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南通大学第六附属医院/盐城市第三人民医院消化科,江苏盐城 224000

南通大学第六附属医院/盐城市第三人民医院普外科,江苏盐城 224000

南通大学附属医院消化科,江苏南通 226001

幽门螺旋杆菌 早期胃癌 内镜下黏膜下剥离术 内镜特点 治疗

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(23)