Kim Sang Gyun
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Clin Endosc. 2016 Jul;49(4):332-5. doi: 10.5946/ce.2016.069. Epub 2016 Jul 20.
Endoscopic resection of early gastric cancer is defined as incomplete when tumor cells are found at the resection margin upon histopathological examination. However, a tumor-positive resection margin does not always indicate residual tumor; it can also be caused by tissue contraction during fixation, by the cautery effect during endoscopic resection, or by incorrect histopathological mapping. Cases of highly suspicious residual tumor require additional endoscopic or surgical resection. For inoperable patients, argon plasma coagulation can be used as an alternative endoscopic treatment. Immediately after the incomplete resection or residual tumor has been confirmed by the pathologist, clinicians should also decide upon any additional treatment to be carried out during the follow-up period.
早期胃癌的内镜切除若在组织病理学检查时发现切除边缘有肿瘤细胞，则定义为切除不完全。然而，肿瘤阳性的切除边缘并不总是意味着存在残留肿瘤；它也可能是由于固定过程中的组织收缩、内镜切除过程中的烧灼效应或组织病理学定位错误所致。高度怀疑有残留肿瘤的病例需要额外的内镜切除或手术切除。对于无法手术的患者，氩离子凝固术可作为一种替代性的内镜治疗方法。在病理学家确认切除不完全或存在残留肿瘤后，临床医生应立即决定在随访期间进行任何额外的治疗。
