Risk factors for synchronous multiple early esophageal cancer and high grade intraepithelial neoplasia
Objective:To identify the risk factors for synchronous multiple early esophageal cancer (EEC) and high grade intraepithelial neoplasia (HGIN).Methods:The medical records of patients with synchronous multiple EEC and HGIN for endoscopic submucosal dissection (ESD) at the First Affiliated Hospital of Zhengzhou University from January 2019 to January 2022 were collected. There were 137 single cases and 24 synchronous multiple cases. The t-test or Mann-Whitney U test and the chi-square test or Fisher exact probability test were used to compare the differences in general clinical characteristics (age, gender, smoking, drinking, hypertension, diabetes, coronary heart disease, abdominal operation history, and family history of gastrointestinal cancer) and pathological characteristics (pathological location, pathological type, infiltration depth, endoscopic classification, lesion length and diameter, and whether there were intestinal metaplasia and erosive gastritis) between the two groups. The independent risk factors for synchronous multiple EEC and HGIN were identified by Logistic regression analysis.Results:Patients with multiple lesions were more likely to have a family history of gastrointestinal tumors (Z2=7.149, P=0.008). When patients were complicated with gastrointestinal metaplasia at the same time, the probability of multiple lesions was higher (P=0.011). Logistic regression analysis showed that family history of gastrointestinal tumors (P=0.009, odds ratio [OR]=3.592, 95% confidence interval CI: 1.375~9.379) and concurrent gastrointestinal metaplasia (P=0.010, OR=22.194, 95%CI: 2.083~236.438) were risk factors for multiple lesions, while other general clinical data and lesion location were not related to multiple lesions.Conclusion:Patients with a family history of gastrointestinal tumors and intestinal metaplasia have a higher risk of suffering synchronous multiple EEC and HGIN. It is recommended to conduct more detailed endoscopic observation, careful endoscopic evaluation, and close follow-up after operation.
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