首页|内镜热损伤术治疗胃低级别上皮内瘤变的临床疗效及术后病理升级的影响因素

内镜热损伤术治疗胃低级别上皮内瘤变的临床疗效及术后病理升级的影响因素

扫码查看
目的 探讨内镜热损伤术治疗胃低级别上皮内瘤变(LGIN)的临床疗效以及术后病理升级的影响因素.方法 选取胃黏膜LGIN患者共98例,所有患者均接受内镜热损伤术治疗,并分析术后1年内的疗效情况;根据术后病理差异分为病理升级组和病理未升级组,采用多因素Logistic回归分析内镜热损伤术后LGIN患者出现病理升级的影响因素.结果 98例患者治愈率术后12个月(82.65%)低于术后3个月(95.92%)、复发率(2.04%)高于术后3个月(11.11%)(P<0.05).单因素结果分析显示,年龄、性别、幽门螺旋杆菌感染、病灶颜色、病变部位与内镜热损伤术后病理升级无关(P>0.05);病变直径、病灶形态、表面溃疡、自发性出血与内镜热损伤术后病理升级有关(P<0.05).多因素Logistic回归分析结果显示,病变直径≥2 cm、凹陷型、有表面溃疡以及有自发性出血是LGIN患者内镜热损伤术后病理升级的独立危险因素(P<0.05).结论 内镜热损伤术治疗胃低级别上皮内瘤变的临床疗效较好,但患者在术后出现病理升级的概率较高,病变直径≥2 cm、凹陷型、有表面溃疡以及有自发性出血是术后病理升级的独立危险因素,临床中需针对高危人群给予积极干预,以减少疾病出现进展的几率.
Clinical Efficacy and Factors Influencing Pathological Upgrading in Patients with Gastric Low-Grade Intraepithelial Neoplasia Underwent Endoscopic Thermal Therapy
Objective To discuss the clinical efficacy and factors influencing pathological upgrading in patients with gastric low-grade intraepithelial neoplasia(LGIN)undergoing endoscopic thermal therapy.Methods 98 patients with gastric LGIN were selected.All patients received endoscopic thermal therapy.The curative effect within 1 year after operation was ana-lyzed.According to the postoperative pathological differences,patients were classified into upgraded group and the non-upgraded group.Then the multivariate Logistic regression analysis was conducted to screen the influencing factors for pathological upgrading of LGIN patients after endoscopic thermal therapy.Results The cure rate was 82.65%at postoperative 12months,which was lower than 95.92%at postoperative 3 months,and the recurrence rate was 2.04%at postoperative 12months,which was higher than 11.11%at postoperative 3 months(P<0.05).Univariate analysis denoted that postoperative pathological upgrading after endoscopic thermal therapy was not associated with age,gender,Helicobacter pylori infection,lesion color,and lesion location(P>0.05),while was associated with lesion diameter,lesion morphology,surface ulcers,and spontaneous bleeding(P<0.05).Mul-tivariate Logistic regression analysis suggested that lesion diameter≥2 cm,depressed type,presence of surface ulcers,and sponta-neous bleeding were independent risk factors for pathological upgrading after endoscopic thermal therapy in LGIN patients(P<0.05).Conclusion Endoscopic thermal therapy is clinically effective in the treatment of LGIN,but patients have a high risk of postoperative pathological upgrading.Lesions diameter ≥ 2 cm,depressed type,presence of surface ulcers,and spontaneous bleed-ing are independent risk factors,so the active clinical interventions are needed in high-risk groups to reduce the chance of disease progression.

Gastric low-grade intraepithelial neoplasiaEndoscopic thermal therapyEfficacyPathological upgradingIn-fluencing factors

高杨、李琳、晁帅恒

展开 >

461000 河南科技大学附属许昌市中心医院

胃低级别上皮内瘤变 内镜热损伤术 疗效 病理升级 影响因素

2024

实用癌症杂志
江西省肿瘤医院 江西省肿瘤研究所

实用癌症杂志

影响因子:1.241
ISSN:1001-5930
年,卷(期):2024.39(8)
  • 10