Suk Sunah, Seo Yeon Joo, Cheung Dae Young, Lee Han Hee, Kim Jin Il, Park Soo-Heon
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Clin Endosc. 2023 Jul;56(4):470-478. doi: 10.5946/ce.2022.259. Epub 2023 Apr 18.
BACKGROUND/AIMS: Metachronous recurrence incidences and risk factors following endoscopic submucosal dissection (ESD) for gastric adenocarcinoma and dysplasias were investigated.
Retrospective review of electronic medical records of patients who underwent gastric ESD at The Catholic University of Korea, Yeouido St. Mary's Hospital.
A total of 190 subjects were enrolled for analysis during the study period. The mean age was 64.4 years-old and the male sex occupied 73.7%. The mean observation period following ESD was 3.45 years. The annual incidence rate of metachronous gastric neoplasms (MGN) was about 3.96%. The annual incidence rate was 5.36% for the low-grade dysplasia group, 6.47% for the high-grade dysplasia group, and 2.74% for the EGC group. MGN was more frequent in the dysplasia group than in the EGC group (p<0.05). For those with MGN development, the mean time interval from ESD to MGN was 4.1 (±1.8) years. By using the Kaplan-Meier model, the estimated mean MGN free survival time was 9.97 years (95% confidence interval, 8.53-11.40) The histological types of MGN were not related to the primary histology types.
MGN following ESD developed in 3.96% annually and MGN was more frequent in the dysplasia group. The histological types of MGN did not correlate with those of primary neoplasm.
背景/目的：研究内镜黏膜下剥离术（ESD）治疗胃腺癌和发育异常后异时性复发的发生率及危险因素。
回顾性分析韩国天主教大学首尔圣母医院接受胃ESD治疗患者的电子病历。
研究期间共纳入190例患者进行分析。平均年龄64.4岁，男性占73.7%。ESD后的平均观察期为3.45年。异时性胃肿瘤（MGN）的年发病率约为3.96%。低级别发育异常组的年发病率为5.36%，高级别发育异常组为6.47%，早期胃癌（EGC）组为2.74%。MGN在发育异常组比EGC组更常见（p<0.05）。对于发生MGN的患者，从ESD到MGN的平均时间间隔为4.1（±1.8）年。采用Kaplan-Meier模型，估计无MGN生存时间的平均值为9.97年（95%置信区间，8.53-11.40）。MGN的组织学类型与原发组织学类型无关。
ESD后MGN的年发生率为3.96%，MGN在发育异常组更常见。MGN的组织学类型与原发性肿瘤的组织学类型无关。
