Han Ji Sun, Jang Jin Seok, Ryu Hwan Cheol, Kim Min Chan, Kim Ki Han, Kim Dong Kyun
Hepatogastroenterology. 2015 Mar-Apr;62(138):512-7.
BACKGROUND/AIMS: Only a small part of visible gas tric mucosal lesion can be removed by endoscopic resection. This study is aimed to identify incidence rate and associated risk factors of multiple and missed gastric lesions, and proper timing of follow-up en doscopy.
Endoscopic surveillance was performed on 1 week, and 1, 6, 12 months af ter endoscopic resection. All multiple gastric lesions were divided into main and accessory lesions. The accessory lesions were subdivided into detected and missed lesions.
Totally, 250 lesions of 215 patients were analyzed. There were 81 early gastric cancers, 50 high grade dysplasias and 119 low grade dysplasias. Thirty patients (14%) had multiple gastric neoplastic lesions, either adenoma or cancer, within 1 year follow-up after endoscopic resection. Old age, male gender and severe intestinal metaplasia were independent risk factors of multiple gastric lesions. Small size (≤ 1 cm) and flat morphology were major risk factors of missed lesion. Among 10 missed lesions, 9 (90%) could be detected within 6 month after resection.
Old age, male gender, severe intestinal metaplasia were risk factors for multiple gastric lesions after endoscopic resection. Follow-up endoscopy is needed at least one time within six months after resection, with careful inspection of entire stomach.
背景/目的：内镜切除仅能切除可见胃黏膜病变的一小部分。本研究旨在确定多发和漏诊胃病变的发生率及相关危险因素，以及随访内镜检查的合适时机。
在内镜切除术后1周、1个月、6个月和12个月进行内镜监测。所有多发胃病变分为主要病变和附属病变。附属病变再细分为已检测到的病变和漏诊病变。
共分析了215例患者的250个病变。其中有81例早期胃癌、50例高级别异型增生和119例低级别异型增生。30例患者（14%）在内镜切除术后1年随访期间出现多发胃肿瘤性病变，包括腺瘤或癌。老年、男性和严重肠化生是多发胃病变的独立危险因素。病变较小（≤1 cm）和平坦形态是漏诊病变的主要危险因素。在10例漏诊病变中，9例（90%）在切除术后6个月内可被检测到。
老年、男性、严重肠化生是内镜切除术后多发胃病变的危险因素。切除术后6个月内至少需要进行一次随访内镜检查，并仔细检查整个胃部。
