Jeong Seok Hoo, An Jungsuk, Kwon Kwang An, Lee Woon Kee, Kim Kyoung Oh, Chung Jun-Won, Kim Yoon Jae, Park Dong Kyun, Kim Jung Ho
Department of Internal Medicine, Catholic Kwandong University International St. Mary's Hospital Department of Pathology Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine Gachon Medical Research Institute Department of Surgery, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.
Medicine (Baltimore). 2017 Jun;96(26):e7088. doi: 10.1097/MD.0000000000007088.
The aim of this study was to elucidate the predictive risk factors of synchronous multiple early gastric cancer regardless of the treatment modality.Patients who underwent early gastric cancer treatment between July 2005 and June 2015 were retrospectively reviewed. In total, 1529 patients who were treated for early gastric cancer were included. We analyzed the patient's data to find predictive factors of synchronous multiple early gastric cancer compared to solitary early gastric cancer. Further analysis was performed to verify the difference between endoscopic and surgical treatment groups.Among the 1529 patients, synchronous multiple early gastric cancer was diagnosed in 68 (4.4%) patients. Significant differences in sex (P = .004), gross appearance (P = .038), depth of invasion (P = .007), and lymphovascular invasion (P = .039) were found between patients with solitary early gastric cancer and synchronous multiple early gastric cancer by univariate analysis. In multivariate analysis, male sex (odds ratio, 2.475; P = .011) and submucosal invasion (odds ratio, 1.850; P = .033) were independent predictive risk factors of synchronous multiple early gastric cancer. In addition, in multivariate analysis, significant differences in age, tumor size, longitudinal location, depth of invasion, and histology were found between patients groups depending on the mode of treatment.Male sex and submucosal invasion were predictive risk factors of synchronous multiple early gastric cancer. Patients with these factors should undergo more meticulous endoscopic surveillance.
本研究的目的是阐明无论治疗方式如何,同步多发早期胃癌的预测风险因素。对2005年7月至2015年6月期间接受早期胃癌治疗的患者进行回顾性研究。总共纳入了1529例接受早期胃癌治疗的患者。我们分析了患者数据,以找出与孤立性早期胃癌相比,同步多发早期胃癌的预测因素。进一步分析以验证内镜治疗组和手术治疗组之间的差异。在这1529例患者中,68例(4.4%)被诊断为同步多发早期胃癌。单因素分析发现,孤立性早期胃癌患者和同步多发早期胃癌患者在性别(P = 0.004)、大体外观(P = 0.038)、浸润深度(P = 0.007)和淋巴管浸润(P = 0.039)方面存在显著差异。多因素分析显示,男性(比值比,2.475;P = 0.011)和黏膜下浸润(比值比,1.850;P = 0.033)是同步多发早期胃癌的独立预测风险因素。此外,多因素分析发现,根据治疗方式不同,患者组在年龄、肿瘤大小、纵向位置、浸润深度和组织学方面存在显著差异。男性和黏膜下浸润是同步多发早期胃癌的预测风险因素。具有这些因素的患者应接受更细致的内镜监测。