Risk factors for submucosal invasion of early gastric differentiated tubular adenocarcinoma
Objective To investigate the risk factors for submucosal invasion of early gastric differentiated tubular adenocarcinoma.Methods The data of 140 patients with early gastric differentiated tubular adenocarcinoma,who underwent endoscopic submucosal dissection(ESD),were retrospectively analyzed,with 148 lesions.Early gastric differentiated tubular adenocarcinoma lesions were categorized into intramucosal infiltration(123 sites)and submucosal infiltration(25 sites)according to the depth of invasion.The baseline characteristics of the patients were statistically analyzed,and univariate and multivariate Logistic regression analyses were performed for submucosal invasion of gastric early differentiated tubular adenocarcinoma.Results Among the 140 patients,there were 113 males(80.71%)and 27 females(19.29%),aged 34-91 years,with a median age of 68(61,73)years.There were 148 lesions in 140 patients,with long diameter ranging 1.5-95 mm and a median of 16(8,26.5)mm;the depth of invasion:123 lesions(83.11%)were confined to the mucous membrane layer(intramucosal invasion),and 25 lesions(16.89%)were infiltrated to the submucosal layer,including 16 lesions infiltrated to the superficial submucosal layer and 9 lesions infiltrated to the deeper submucosal layer.There were 75 highly differentiated tubular adenocarcinomas,61 moderately differentiated tubular adenocarcinomas,and 12 moderately differentiated tubular adenocarcinomas.Univariate analysis showed that there was no significant difference in gender,age,lesion location,endoscopic morphology,mucous phenotype,immunohistochemical P53 positive and Ki67>50%expression between patients with intramucosal invasion and submucosal layer(P>0.05).The difference was statistically significant(P<0.05)when comparing the percentage of long diameter≥2 cm and a moderately differentiated component by histology between patients with intramucosal invasion and submucosal layer invasion.Further multifactorial Logistic regression analysis of the results that were significant in the univariate analysis(whether the long diameter was≥2 cm,whether the histology had a moderately differentiated component or not)showed that:the long diameter≥2 cm[OR=2.808,95%CI=(1.050,7.508),P=0.040<0.05],a moderately differentiated component by histology[OR=6.080,95%CI=(1.937,19.086),P=0.002<0.05]were independent risk factors for submucosal invasion of early gastric differentiated tubular adenocarcinoma.Conclusion The lesions with long diameter≥2 cm or moderately differentiated components by histology are more likely to infiltrate the submucosal layer in early gastric differentiated tubular adenocarcinoma.
Early gastric cancerTubular adenocarcinomaInvasion depthRisk factors
NETL
NSTL
万方数据
维普
