Wen Jing, Yan Bin, Yang Jing, Lu Zhongsheng, Bian Xuqiang, Huang Jin
Department of Gastroenterology and Hepatology, Chinese PLA 984 Hospital, Beijing, China.
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China.
Wideochir Inne Tech Maloinwazyjne. 2020 Jun;15(2):276-282. doi: 10.5114/wiitm.2019.89192. Epub 2019 Nov 4.
Endoscopic resection for the treatment of gastrointestinal neuroendocrine tumors has a risk of resection margin residues. The related risk factors and prognosis of post-endoscopic resection margin residues have not been fully evaluated.
To investigate the associated risk factors and prognostic impact of resection margin residues after endoscopic resection of gastrointestinal neuroendocrine tumors.
We conducted a retrospective analysis of 129 patients who underwent endoscopic resection for the treatment of gastrointestinal neuroendocrine tumors. Sex, age, location, diameter of tumor, depth of invasion, endoscopic treatment methods, endoscopic ultrasonography (EUS) evaluation, and the work experience of endoscopists were evaluated as potential risk factors. In addition, the prognoses of patients with positive resection margins were analyzed.
A total of 18 (18/129, 14.0%) patients exhibited positive resection margins after endoscopic resection. Among 16 successfully followed-up patients, 1 died due to rupture of pulmonary artery aneurysms, 2 underwent supplementary surgical operations, and 2 underwent additional endoscopic submucosal dissection. The remaining 11 patients were periodically followed up, and no recurrences were found. The results of univariate analysis suggested that endoscopic treatment method, the depth of invasion, and EUS evaluation correlated with positive resection margin. Multivariate regression analysis suggested that the depth of invasion and EUS evaluation were risk factors for resection margin residues.
The depth of invasion and EUS evaluation are independent risk factors for positive resection margins after endoscopic resection. This finding suggests that a greater depth of invasion increases the risk for positive resection margins, while EUS evaluation before resection decreases this risk.
内镜切除治疗胃肠道神经内分泌肿瘤存在切缘残留风险。内镜切除术后切缘残留的相关危险因素及预后尚未得到充分评估。
探讨胃肠道神经内分泌肿瘤内镜切除术后切缘残留的相关危险因素及预后影响。
我们对129例行内镜切除治疗胃肠道神经内分泌肿瘤的患者进行了回顾性分析。将性别、年龄、肿瘤位置、直径、浸润深度、内镜治疗方法、内镜超声（EUS）评估以及内镜医师的工作经验作为潜在危险因素进行评估。此外，还对切缘阳性患者的预后进行了分析。
共有18例（18/129，14.0%）患者在内镜切除术后出现切缘阳性。在16例成功随访的患者中，1例因肺动脉瘤破裂死亡，2例接受了补充手术，2例接受了额外的内镜黏膜下剥离术。其余11例患者定期随访，未发现复发。单因素分析结果表明，内镜治疗方法、浸润深度和EUS评估与切缘阳性相关。多因素回归分析表明，浸润深度和EUS评估是切缘残留的危险因素。
浸润深度和EUS评估是内镜切除术后切缘阳性的独立危险因素。这一发现表明，浸润深度增加会增加切缘阳性的风险，而切除前的EUS评估可降低这种风险。
