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根除治疗对胃腺瘤内镜下黏膜下剥离术后异时性胃肿瘤预防的影响

Effect of Eradication Treatment on Metachronous Gastric Neoplasm Prevention Following Endoscopic Submucosal Dissection for Gastric Adenoma.

作者信息

Noh Choong-Kyun, Lee Eunyoung, Park Bumhee, Lim Sun Gyo, Shin Sung Jae, Lee Kee Myung, Lee Gil Ho

机构信息

Department of Gastroenterology, Ajou University School of Medicine, Suwon 16499, Republic of Korea.

Department of Biomedical Informatics, Ajou University School of Medicine, Suwon 16499, Republic of Korea.

出版信息

J Clin Med. 2023 Feb 14;12(4):1512. doi: 10.3390/jcm12041512.

Abstract

The long-term effect of eradication on metachronous gastric neoplasm prevention after endoscopic submucosal dissection (ESD) of gastric adenoma is unclear. This study included patients with confirmed infection after ESD with curative resection for gastric adenoma. Patients were divided based on the success of eradication treatment into two groups: eradication and non-eradication. Patients with any newly detected lesion within 1 year after ESD and recurrence at the ESD site were excluded from the analysis. Further, 1:1 propensity score matching was also performed to eliminate baseline differences between the two groups. eradication treatment was administered to 673 patients after ESD (163 in the successful eradication group and 510 in the non-eradication group). During the median follow-up periods of 25 and 39 months in the eradication and non-eradication groups, metachronous gastric neoplasm was identified in 6 (3.7%) and 22 patients (4.3%), respectively. Adjusted Cox analysis revealed that eradication was not associated with increased risk of metachronous gastric neoplasm after ESD. Kaplan-Meier analysis in the matched population yielded similar findings ( = 0.546). eradication treatment was not associated with metachronous gastric neoplasm after ESD with curative resection for gastric adenoma.

摘要

内镜下黏膜下剥离术(ESD)切除胃腺瘤后,根除[某种因素]对预防异时性胃肿瘤的长期影响尚不清楚。本研究纳入了因胃腺瘤接受ESD根治性切除术后确诊[某种感染]的患者。根据根除治疗是否成功将患者分为两组:根除组和未根除组。ESD术后1年内任何新发现的病变以及ESD部位复发的患者均被排除在分析之外。此外,还进行了1:1倾向评分匹配以消除两组之间的基线差异。ESD术后对673例患者进行了根除治疗(成功根除组163例,未根除组510例)。在根除组和未根除组分别为25个月和39个月的中位随访期内,分别有6例(3.7%)和22例(4.3%)患者被确诊为异时性胃肿瘤。校正后的Cox分析显示,ESD术后根除[某种因素]与异时性胃肿瘤风险增加无关。匹配人群中的Kaplan-Meier分析得出了类似的结果(P = 0.546)。对于因胃腺瘤接受根治性切除的ESD术后患者,根除治疗与异时性胃肿瘤无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca05/9962017/73b89683880f/jcm-12-01512-g001.jpg

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