Chung Chang Su, Woo Hyun Sun, Chung Jun Won, Jeong Seok Hoo, Kwon Kwang An, Kim Yoon Jae, Kim Kyoung Oh, Park Dong Kyun
Division of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Korea.
Division of Gastroenterology, Department of Internal Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon, Korea.
J Korean Med Sci. 2017 Mar;32(3):421-426. doi: 10.3346/jkms.2017.32.3.421.
Although endoscopic submucosal dissection (ESD) is widely accepted as a curative treatment method for early gastric cancer (EGC) worldwide, metachronous recurrence often occurs after ESD for EGC. However, there are insufficient data about the role of Helicobacter pylori (H. pylori) infection and other risk factors for recurrence. We aimed to compare the metachronous lesion in the H. pylori persistent group and the eradicated group, and to identify risk factors for metachronous lesion. We retrospectively analyzed 782 patients who underwent ESD between January 2008 and December 2013. We excluded patients with dysplasia or patients who were not tested for H. pylori infection. One hundred eighty-five patients were enrolled. We studied risk factors for recurrence, and used survival analysis to test. There were 24 patients with metachronous recurrence after ESD for EGC among the group. The incidence of metachronous gastric lesions after ESD for EGC developed more in the over 70-year-old group (P = 0.025) and more in the H. pylori persistent group (P = 0.008). In conclusion, H. pylori infection and old age are independent risk factors for metachronous gastric lesions after ESD in EGC.
尽管内镜黏膜下剥离术（ESD）作为早期胃癌（EGC）的一种根治性治疗方法在全球范围内被广泛接受，但EGC行ESD术后常发生异时性复发。然而，关于幽门螺杆菌（H. pylori）感染及其他复发危险因素的作用，相关数据尚不充分。我们旨在比较H. pylori持续感染组和根除组的异时性病变情况，并确定异时性病变的危险因素。我们回顾性分析了2008年1月至2013年12月期间接受ESD治疗的782例患者。我们排除了发育异常患者或未检测H. pylori感染的患者。最终纳入185例患者。我们研究了复发的危险因素，并采用生存分析进行检验。该组中EGC行ESD术后有24例发生异时性复发。EGC行ESD术后异时性胃部病变的发生率在70岁以上组更高（P = 0.025），在H. pylori持续感染组也更高（P = 0.008）。总之，H. pylori感染和高龄是EGC行ESD术后异时性胃部病变的独立危险因素。
