Su Jing, Wei Shuchun, Li Wenjie, Chen Han, Li Lurong, Xu Lijuan, Zhao Ping, Zhang Guoxin, Yan Jin
Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Gastroenterology, Xuzhou Central Hospital, The Xuzhou School of Clinical Medicine of Nanjing Medical University, Xuzhou, Jiangsu, China.
Front Oncol. 2023 Aug 17;13:1219451. doi: 10.3389/fonc.2023.1219451. eCollection 2023.
With the development of endoscopic technology, the detection rate of synchronous multiple primary early esophageal cancer (SMPEEC) is increasing; however, the risk factors remain unclear. We aimed to assess the clinicopathological characteristics of patients with SMPEEC and investigate the risk factors contributing to the development of multiple lesions.
A retrospective cohort study was conducted on 911 consecutive patients who underwent Endoscopic submucosal dissection (ESD) for primary esophageal neoplasms from January 2013 to June 2021. The patients were divided into the SMPEEC group and the solitary early esophageal cancer (SEEC) group. We compared the differences in clinicopathological characteristics between the two groups and investigated the risk factors linked to multiple lesions. Additionally, we investigated the relationship between the main and accessory lesions.
A total of 87 SMPEEC patients were included in this study, and the frequency of synchronous multiple lesions was 9.55% in patients with early esophageal cancer. The lesions in the SMPEEC group were mainly located in the lower segment of the esophagus (46[52.9%]), whereas those in the SEEC group were in the middle segment (412[50.0%]). The pathology type, tumor location, and circumferential rate of lesions were independent risk factors(<0.05) for SMPEEC by logistic regression analysis. Significant positive correlations were observed between the main and accessory lesions in terms of morphologic type (r=0.632, =0.000), tumor location(r=0.325, =0.037), pathologic type (r=0.299, =0.003), and depth of invasion (r=0.562, =0.000).
Pathology type, tumor location, and circumferential rate of lesions were identified as independent risk factors for SMEPPC. Understanding these risk factors and the correlation between the main and accessory lesions could significantly improve the detection rate of SMPEEC.
随着内镜技术的发展，同步性多原发性早期食管癌（SMPEEC）的检出率不断提高；然而，其危险因素仍不明确。我们旨在评估SMPEEC患者的临床病理特征，并探讨导致多发病变发生的危险因素。
对2013年1月至2021年6月期间连续911例行内镜黏膜下剥离术（ESD）治疗原发性食管肿瘤的患者进行回顾性队列研究。将患者分为SMPEEC组和孤立性早期食管癌（SEEC）组。我们比较了两组临床病理特征的差异，并研究了与多发病变相关的危险因素。此外，我们还研究了主病灶和副病灶之间的关系。
本研究共纳入87例SMPEEC患者，早期食管癌患者同步多发病变的发生率为9.55%。SMPEEC组的病变主要位于食管下段（46例[52.9%]），而SEEC组的病变主要位于食管中段（412例[50.0%]）。经逻辑回归分析，病理类型、肿瘤位置和病变环周率是SMPEEC的独立危险因素（<0.05）。主病灶和副病灶在形态学类型（r=0.632，P=0.000）、肿瘤位置（r=0.325，P=0.037）、病理类型（r=0.299，P=0.003）和浸润深度（r=0.562，P=0.000）方面存在显著正相关。
病理类型、肿瘤位置和病变环周率被确定为SMEPPC的独立危险因素。了解这些危险因素以及主病灶和副病灶之间的相关性可显著提高SMPEEC的检出率。
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