Zhang Yong-Hua, Ma Chao, Huang Xiao-Mei, Liu Yang
Department of General Surgery, Chonggang General Hospital, Chongqing 400080, China.
Department of Gastroenterology, Chonggang General Hospital, Chongqing 400080, China.
World J Gastrointest Surg. 2025 Jan 27;17(1):94873. doi: 10.4240/wjgs.v17.i1.94873.
Identifying factors that influence non-curative resection (NCR) is critical to optimize treatment strategies and improve patient outcomes in patients with early gastric cancer (EGC).
To investigate the factors influencing the NCR of EGC and to evaluate the predictive value of these factors.
The clinical data of 173 patients with EGC admitted between July 2020 and July 2023 were retrospectively collected. According to radical resection criteria, the patients were further divided into curative resection group ( = 143) and NCR group ( = 30). Clinical information was collected, including surgical method, tumor diameter, tumor site, ulcer formation, depth of invasion, pathological type, and lymph node metastasis. Logistic regression analysis was used to explore the factors affecting non-curable resection.
Multivariate logistic regression analysis showed that ulcer formation [odds ratio (OR) = 3.53; 95% confidence interval (CI): 1.55-8.01, = 0.003], pathological type (OR = 3.73; 95%CI: 1.60-8.74, = 0.002), tumor diameter (OR = 3.15; 95%CI: 1.40-7.05, = 0.005), tumor location (OR = 3.50; 95%CI: 1.16-10.58, = 0.027), lymph node metastasis (OR = 4.40; 95%CI: 1.83-10.57, = 0.001), and depth of penetration (OR = 3.75; 95%CI: 1.60-8.74, = 0.002) were all risk factors for NCR in EGC patients. Predictive analysis showed varying area under the curve values for factors such as tumor diameter (0.636), tumor location (0.608), ulcer formation (0.652), infiltration depth (0.658), pathological type (0.656), and lymph node metastasis (0.674).
The results suggest that factors such as tumor diameter, tumor location, ulcer formation, depth of invasion, pathological type, and lymph node metastasis increase the risk of NCR in EGC patients.
识别影响非根治性切除（NCR）的因素对于优化早期胃癌（EGC）患者的治疗策略和改善患者预后至关重要。
探讨影响EGC非根治性切除的因素，并评估这些因素的预测价值。
回顾性收集2020年7月至2023年7月收治的173例EGC患者的临床资料。根据根治性切除标准，将患者进一步分为根治性切除组（n = 143）和非根治性切除组（n = 30）。收集临床信息，包括手术方式、肿瘤直径、肿瘤部位、溃疡形成、浸润深度、病理类型和淋巴结转移情况。采用Logistic回归分析探讨影响非根治性切除的因素。
多因素Logistic回归分析显示，溃疡形成（比值比[OR]=3.53；95%置信区间[CI]：1.55 - 8.01，P = 0.003）、病理类型（OR = 3.73；95%CI：1.60 - 8.74，P = 0.002）、肿瘤直径（OR = 3.15；95%CI：1.40 - 7.05，P = 0.005）、肿瘤位置（OR = 3.50；95%CI：1.16 - 10.58，P = 0.027）、淋巴结转移（OR = 4.40；95%CI：1.83 - 10.57，P = 0.001）和浸润深度（OR = 3.75；95%CI：1.60 - 8.74，P = 0.002）均为EGC患者非根治性切除的危险因素。预测分析显示，肿瘤直径（0.636）、肿瘤位置（0.608）、溃疡形成（0.652）、浸润深度（0.658）、病理类型（0.656）和淋巴结转移（0.674）等因素的曲线下面积值各不相同。
结果表明，肿瘤直径、肿瘤位置、溃疡形成、浸润深度、病理类型和淋巴结转移等因素增加了EGC患者非根治性切除的风险。
