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Gastric Cancer:直径大于2cm的早期胃癌是影响内镜切除术治疗效果的**影响因素

2020-08-25 MedSci原创 MedSci原创

现代人压力大、生活环境变差,癌症的发生率也越来越高,其中胃癌更是中国人最常见的癌症问题。

        现代人压力大、生活环境变差,癌症的发生率也越来越高,其中胃癌更是中国人最常见的癌症问题。对于胃癌的治疗,目前最有效的治疗方法便是对胃癌部位进行手术切除,但是随着医学技术的进步和发展,手术的的方式也得到了愈来愈好的改进,如胃癌的胃切除手术已经可以在内镜下进行切除,这种手术方式不仅能够有助于患者术后恢复、提高预后,是非常好的手术方式。

 

        什么时候可以做内镜下切除呢,这主要跟胃癌肿瘤的分期有关,胃癌的发展可以分为四期,其中一期胃癌属于早期胃癌,这一期里胃癌刚出现,位置较为局限,还未出现转移或局部浸润的情况,二三期属于进展期胃癌,可以出现不同程度的粘膜下浸润;四期属于晚期胃癌一般就已经不能进行内镜下切除。一般来早期胃癌,是适宜利用内镜下切除的,但是效果也是参差不齐。具体什么因素影响了内镜下治疗效果,最近有研究人员进行了相关的探究。

 

        在2005年至2014年间,研究人员对韩国18家三级医院的1123例接受内镜下切除的早期胃癌(EGC)患者进行了分析,总共有216例EGC患者粘膜内> 2 cm肿瘤被完全切除,切除切缘阴性,没有溃疡和淋巴血管浸润。 根据内镜切除后治疗,将患者分为附加手术组(n  = 40)或观察组(n = 176),进行随访观察。

DOI:10.1007/s10120-020-01115-y

         结果显示在手术组中未观察到淋巴结转移(LN)或远处转移或与癌症相关的死亡率。在观察组中,有2名(1.1%)患者发生了LN或远处转移,其5年累积风险为0.7%,其中1名(0.6%)患者死于胃癌。观察组的5年和8年总生存率分别为94.1%和89.9%,而手术组分别为100.0%和95.2%(log-rank P= 0.159)。Cox回归分析未显示观察组与死亡率增加之间的关联。

 

         因此,研究最后作者说道:LN或远处转移的风险不可忽略,但肿瘤大小> 2 cm是唯一的非治愈性因素。

 

原始出处:

Hyo-Joon Yang. Et al. Clinical outcomes of endoscopic resection for undifferentiated intramucosal early gastric cancer larger than 2 cm. Gastric Cancer.2020.

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encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Mon Jun 14 00:13:40 CST 2021, time=2021-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893690, encodeId=4e7d1893690a2, content=<a href='/topic/show?id=4fc4e85161' target=_blank style='color:#2F92EE;'>#gastric#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7851, encryptionId=4fc4e85161, topicName=gastric)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b30126, createdName=skhzy, createdTime=Sat Jan 16 09:13:40 CST 2021, time=2021-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894174, encodeId=6e2c18941e4a2, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, 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time=2020-08-27, status=1, ipAttribution=)]
  5. 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level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Wed Apr 07 03:13:40 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=915981, encodeId=daa4915981f8, content=受教了,值得好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fa7b5413394, createdName=珠珠, createdTime=Tue Jan 12 18:26:04 CST 2021, time=2021-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814207, encodeId=4fb881420eec, content=好资料, beContent=null, objectType=article, channel=null, level=null, likeNumber=208, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 18:22:23 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814206, encodeId=eaf481420692, content=好资料, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 18:22:20 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814121, encodeId=eaab814121a5, content=胃镜常规复查吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 17:33:42 CST 2020, time=2020-08-27, status=1, ipAttribution=)]
    2021-01-16 skhzy
  6. 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time=2020-08-27, status=1, ipAttribution=)]
  7. 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authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 18:22:23 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814206, encodeId=eaf481420692, content=好资料, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 18:22:20 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814121, encodeId=eaab814121a5, content=胃镜常规复查吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 17:33:42 CST 2020, time=2020-08-27, status=1, ipAttribution=)]
    2021-01-12 珠珠

    受教了,值得好好学习

    0

  8. 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encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Mon Jun 14 00:13:40 CST 2021, time=2021-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893690, encodeId=4e7d1893690a2, content=<a href='/topic/show?id=4fc4e85161' target=_blank style='color:#2F92EE;'>#gastric#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7851, encryptionId=4fc4e85161, topicName=gastric)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b30126, createdName=skhzy, createdTime=Sat Jan 16 09:13:40 CST 2021, time=2021-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894174, encodeId=6e2c18941e4a2, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Wed Apr 07 03:13:40 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=915981, encodeId=daa4915981f8, content=受教了,值得好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fa7b5413394, createdName=珠珠, createdTime=Tue Jan 12 18:26:04 CST 2021, time=2021-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814207, encodeId=4fb881420eec, content=好资料, beContent=null, objectType=article, channel=null, level=null, likeNumber=208, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 18:22:23 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814206, encodeId=eaf481420692, content=好资料, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 18:22:20 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814121, encodeId=eaab814121a5, content=胃镜常规复查吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 17:33:42 CST 2020, time=2020-08-27, status=1, ipAttribution=)]
    2020-08-27 ms4000002082197205

    好资料

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2073086, encodeId=0ea920e3086e2, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Mon May 24 16:13:40 CST 2021, time=2021-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712524, encodeId=ddda1e1252457, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sun Dec 06 20:13:40 CST 2020, time=2020-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043172, encodeId=1dc520431e22b, content=<a href='/topic/show?id=9c9230564c7' target=_blank style='color:#2F92EE;'>#内镜切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30564, encryptionId=9c9230564c7, topicName=内镜切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec53439, createdName=zhty5337, createdTime=Sat Oct 24 09:13:40 CST 2020, time=2020-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877326, encodeId=c6d618e73263d, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Mon Jun 14 00:13:40 CST 2021, time=2021-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893690, encodeId=4e7d1893690a2, content=<a href='/topic/show?id=4fc4e85161' target=_blank style='color:#2F92EE;'>#gastric#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7851, encryptionId=4fc4e85161, topicName=gastric)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b30126, createdName=skhzy, createdTime=Sat Jan 16 09:13:40 CST 2021, time=2021-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894174, encodeId=6e2c18941e4a2, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Wed Apr 07 03:13:40 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=915981, encodeId=daa4915981f8, content=受教了,值得好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fa7b5413394, createdName=珠珠, createdTime=Tue Jan 12 18:26:04 CST 2021, time=2021-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814207, encodeId=4fb881420eec, content=好资料, beContent=null, objectType=article, channel=null, level=null, likeNumber=208, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 18:22:23 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814206, encodeId=eaf481420692, content=好资料, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 18:22:20 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814121, encodeId=eaab814121a5, content=胃镜常规复查吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 17:33:42 CST 2020, time=2020-08-27, status=1, ipAttribution=)]
    2020-08-27 ms4000002082197205

    好资料

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=2073086, encodeId=0ea920e3086e2, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Mon May 24 16:13:40 CST 2021, time=2021-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712524, encodeId=ddda1e1252457, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sun Dec 06 20:13:40 CST 2020, time=2020-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043172, encodeId=1dc520431e22b, content=<a href='/topic/show?id=9c9230564c7' target=_blank style='color:#2F92EE;'>#内镜切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30564, encryptionId=9c9230564c7, topicName=内镜切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec53439, createdName=zhty5337, createdTime=Sat Oct 24 09:13:40 CST 2020, time=2020-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877326, encodeId=c6d618e73263d, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Mon Jun 14 00:13:40 CST 2021, time=2021-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893690, encodeId=4e7d1893690a2, content=<a href='/topic/show?id=4fc4e85161' target=_blank style='color:#2F92EE;'>#gastric#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7851, encryptionId=4fc4e85161, topicName=gastric)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b30126, createdName=skhzy, createdTime=Sat Jan 16 09:13:40 CST 2021, time=2021-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894174, encodeId=6e2c18941e4a2, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Wed Apr 07 03:13:40 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=915981, encodeId=daa4915981f8, content=受教了,值得好好学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fa7b5413394, createdName=珠珠, createdTime=Tue Jan 12 18:26:04 CST 2021, time=2021-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814207, encodeId=4fb881420eec, content=好资料, beContent=null, objectType=article, channel=null, level=null, likeNumber=208, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 18:22:23 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814206, encodeId=eaf481420692, content=好资料, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 18:22:20 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814121, encodeId=eaab814121a5, content=胃镜常规复查吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ce05381686, createdName=ms4000002082197205, createdTime=Thu Aug 27 17:33:42 CST 2020, time=2020-08-27, status=1, ipAttribution=)]
    2020-08-27 ms4000002082197205

    胃镜常规复查吗

    0

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