Shibukawa Narihiro, Ouchi Shohei, Wakamatsu Shuji, Wakahara Yuhei, Kaneko Akira
Narihiro Shibukawa, Shohei Ouchi, Shuji Wakamatsu, Yuhei Wakahara, Akira Kaneko, Department of Gastroenterology, NTT West Osaka Hospital, Tennoji-ku, Osaka 543-8922, Japan.
World J Gastrointest Oncol. 2017 Aug 15;9(8):327-332. doi: 10.4251/wjgo.v9.i8.327.
To investigate predictive markers for metachronous and synchronous gastric cancer (GC), which can develop after endoscopic submucosal dissection (ESD).
A total of 352 patients underwent ESD for early GC at NTT West Osaka Hospital between June 2006 and February 2016. Exclusion criteria were as follows: Remnant stomach, unknown status, and endoscopic observation of the whole stomach outside our hospital. We analyzed data from 192 patients comprising 109 patients with solitary GC (Group A) and 83 with metachronous and synchronous GC (Group B). We retrospectively investigated the clinicopathological and endoscopic characteristics, and endoscopic risk score as predictive markers for GC.
The median age of Group B [72 years (interquartile range 63-78)] was significantly higher than that of Group A [66 years (interquartile range 61-74), respectively, = 0.0009]. The prevalence of intestinal metaplasia in Group B tended to be higher than that in Group A (57.8% 45.0%, = 0.08). The prevalence of gastric xanthoma (GX) in Group B was significantly higher than that in Group A (54.2% 32.1%, = 0.003). The atrophy score in Group B was significantly higher than that in Group A ( = 0.005). Multivariate analysis revealed that higher age and the presence of GX were independently related to metachronous and synchronous GC [OR = 1.04 (1.01-1.08), = 0.02; and OR = 2.11 (1.14-3.99), = 0.02, respectively].
The presence of GX is a useful predictive marker for metachronous and synchronous GC.
研究内镜黏膜下剥离术（ESD）后可能发生的异时性和同时性胃癌（GC）的预测标志物。
2006年6月至2016年2月期间，共有352例早期胃癌患者在NTT西大阪医院接受了ESD治疗。排除标准如下：残胃、情况不明以及在我院以外医院对全胃进行的内镜观察。我们分析了192例患者的数据，其中包括109例孤立性胃癌患者（A组）和83例异时性和同时性胃癌患者（B组）。我们回顾性研究了临床病理和内镜特征，以及内镜风险评分作为胃癌的预测标志物。
B组的中位年龄[72岁（四分位间距63 - 78）]显著高于A组[分别为66岁（四分位间距61 - 74），P = 0.0009]。B组肠化生的发生率倾向于高于A组（57.8%对45.0%，P = 0.08）。B组胃黄色瘤（GX）的发生率显著高于A组（54.2%对32.1%，P = 0.003）。B组的萎缩评分显著高于A组（P = 0.005）。多因素分析显示，较高的年龄和GX的存在与异时性和同时性胃癌独立相关[OR = 1.04（1.01 - 1.08），P = 0.02；OR = 2.11（1.14 - 3.99），P = 0.02]。
GX的存在是异时性和同时性胃癌的有用预测标志物。
