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中华胃肠内镜电子杂志 ›› 2024, Vol. 11 ›› Issue (04) : 238 -242. doi: 10.3877/cma.j.issn.2095-7157.2024.04.004

论著

不同年龄段胃低级别上皮内瘤变患者内镜下射频消融术的疗效对比分析
王楠钧1, 马燕1, 李隆松1, 牛晓彤1, 刘圣圳1, 毕雅维1, 苏松1, 柴宁莉1,(), 令狐恩强1,()   
  1. 1.100853 北京,解放军总医院第一医学中心消化内科医学部
  • 收稿日期:2024-08-07 出版日期:2024-11-15
  • 通信作者: 柴宁莉, 令狐恩强
  • 基金资助:
    国家重点研发计划(2022YFC2503600)解放军总医院青年自主创新科学基金(22QNFC028)

Comparative analysis of the efficacy of endoscopic radiofrequency ablation in patients with gastric low-grade intraepithelial neoplasia of different age gr

Nanjun Wang1, Yan Ma1, Longsong Li1, Xiaotong Niu1, Shengzhen Liu1, Yawei Bi1, Song Su1, Ningli Chai1,(), Enqiang Linghu1,()   

  1. 1.Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital Beijing 100853, China
  • Received:2024-08-07 Published:2024-11-15
  • Corresponding author: Ningli Chai, Enqiang Linghu
引用本文:

王楠钧, 马燕, 李隆松, 牛晓彤, 刘圣圳, 毕雅维, 苏松, 柴宁莉, 令狐恩强. 不同年龄段胃低级别上皮内瘤变患者内镜下射频消融术的疗效对比分析[J/OL]. 中华胃肠内镜电子杂志, 2024, 11(04): 238-242.

Nanjun Wang, Yan Ma, Longsong Li, Xiaotong Niu, Shengzhen Liu, Yawei Bi, Song Su, Ningli Chai, Enqiang Linghu. Comparative analysis of the efficacy of endoscopic radiofrequency ablation in patients with gastric low-grade intraepithelial neoplasia of different age gr[J/OL]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2024, 11(04): 238-242.

目的

探索内镜下射频消融术(RFA)治疗胃低级别上皮内瘤变(LGIN)的老年患者与非老年患者之间的疗效差异, 为进一步提高RFA 的临床疗效提供依据。

方法

回顾性纳入2014 年10 月至2022 年10 月经解放军总医院第一医学中心消化内科医学部行RFA 治疗的胃LGIN 且随访满2 年的患者共104例,其中老年患者51例、非老年患者53例。 对比两组患者在一般临床特征、内镜治疗及随访结果方面的差异,并探索其潜在原因。

结果

两组患者在年龄、萎缩性胃炎、肠上皮化生方面存在明显差异,在性别、病程、病变的部位、大小、表面形态、幽门螺旋杆菌感染、术后复发、再发,以及进展方面的差异无统计学意义。 老年患者术后相对更容易复发,而萎缩性胃炎、肠上皮化生、Hp 感染,以及病程超过1 年可能是导致复发的潜在因素。

结论

胃LGIN 的老年患者在RFA 术后相对更容易复发。 有效的控制萎缩性胃炎、肠上皮化生,积极根除Hp 感染,并在确诊胃LGIN 后尽早接受内镜下RFA,有望进一步改善RFA 的疗效。

Objective

We conducted the clinical comparative studies to clarify the difference in efficacy between elderly patients and non-elderly patients with endoscopic radiofrequency ablation (RFA) for the treatment of gastric low-grade intraepithelial neoplasia (LGIN), and actively explored the possible causes to provide theoretical basis for further improving the clinical efficacy of RFA.

Methods

A total of 104 patients with gastric LGIN who received RFA at the First Medical Center of the Chinese PLA General Hospital from October 2014 to October 2022 and were followed up for more than 2 year were retrospectively selected, including 51 elderly patients and 53 non-elderly patients.Subsequently, through relevant statistical analysis, the differences in general information, endoscopy-related data,and follow-up results between the two groups were clarified, and the potential causes were explored.

Results

There were significant differences in age,atrophic gastritis and intestinal metaplasia between thetwogroups,but there were no statistically significant differences in gender,course of disease,lesion location,size,surface morphology,helicobacter pylori (Hp) infection,postoperative relapse, recurrence,and progression. Elderly patients are more likely to relapse after RFA, and atrophic gastritis,intestinal metaplasia,Hp infection,and disease duration of more than 1 year may be potential factors leading to relapse.

Conclusion

Elderly patients with gastric LGIN are relatively more likely to relapse after RFA.Effectively control atrophic gastritis and intestinal metaplasia,actively eradicate Hp infection, and receive endoscopic RFA as earlier as possible after the diagnosis of gastric LGIN are expected to further improve the efficacy of RFA.

表1 老年组与非老年组患者的临床资料对比[例(%)]
表2 老年组与非老年组 RFA 术后患者复发的危险因素分析(例)
表3 RFA 术后复发的危险因素分析(例)
[1]
北京医学会消化内镜学分会.胃低级别上皮内瘤变规范化诊治专家共识(2019,北京)[J/CD]. 中华胃肠内镜电子杂志,2019,6(2):49-56.
[2]
Tanabe H, Mizukami Y, Takei H, et al. Clinicopathological characteristics of Epstein-Barr virus and microsatellite instability subtypes of early gastric neoplasms classified by the Japanese and the World Health Organization criteria[J]. J Pathol Clin Res,2021,7(4):397-409.
[3]
冯佳,令狐恩强.胃低级别上皮内瘤变的内镜诊疗技术进展[J/CD].中华胃肠内镜电子杂志,2017,4(1):29-32.
[4]
邹龙,杨爱明. 胃黏膜低级别上皮内瘤变诊治的研究进展[J].中华消化内镜杂志,2018,35(7):527-529.
[5]
Quiroz-Guadarrama CD,Herrera-Esquivel JJ,Rojano-Rodríguez M, et al. Endoscopic gastric submucosal dissection in low-grade intraepithelial neoplasia[J]. Rev Gastroenterol Mex,2014,79(2):149-151.
[6]
Baldaque-Silva F,Cardoso H,Lopes J,et al.Radiofrequency ablation for the treatment of gastric dysplasia:a pilot experienee in three patients[J].Eur J Gastroenterol Hepatol,2013,25(7):863-868.
[7]
Leung WK, Tong DK, Leung SY, et al. Treatnmnt of Gastric Metaplasia or Dysplasia by Endoscopic Radiofrequency Ablation:A Pilot Study[J]. Hepatogastroenterology,2015,62(139):748-751.
[8]
王楠钧,柴宁莉,令狐恩强,等. 内镜下射频消融术治疗胃低级别上皮内瘤变的临床研究[J/CD]. 中华胃肠内镜电子杂志,2020,7(3):117-120.
[9]
Wang NJ, Chai NL, Tang XW, et al. Clinical efficacy and prognostic risk factors of endoscopic radiofrequency ablation for gastric low-grade intraepithelial neoplasia [ J ]. World J Gastrointest Oncol,2022,14(3):724-733.
[10]
Wang N, Chai N, Li L, et al. Comparison of Endoscopic Radiofrequency Ablation and Argon Plasma Coagulation in Patients with Gastric Low-Grade Intraepithelial Neoplasia:A Large-Scale Retrospective Study [ J]. Can J Gastroenterol Hepatol,2022,2022:2349940.
[11]
Niu X,Wang N,Wang Y,et al. Role of submucosal injection in radiofrequency ablation of gastric low-grade dysplasia:Effects on symptoms and outcomes[J]. Chin Med J (Engl),2024,137(17):2099-2110.
[12]
Schlemper RJ, Riddell RH, Kato Y, et al. The Vienna classification of gastrointestinal epithelial neoplasia[J]. Gut,2000,47(2):251-255.
[13]
Dixon MF. Gastrointestinal epithelial neoplasia:Vienna revisited[J]. Gut, 2002,51(1):130-131.
[14]
Tanabe H, Mizukami Y, Takei H, et al. Clinicopathological characteristics of Epstein-Barr virus and microsatellite instability subtypes of early gastric neoplasms classified by the Japanese and the World Health Organization criteria[J]. J Pathol Clin Res,2021,7(4):397-409.
[15]
陈巍峰,李全林,周平红,等. 不同染色放大内镜方法在早期胃癌及癌前病变筛查中临床价值的前瞻性评估[J]. 中华胃肠外科杂志,2012, 15(7):662-667.
[16]
Li YF,Xia R,Zhang B,et al.Chronic Atrophic Gastritis:A Review[J].J Environ Pathol Toxicol Oncol,2018,37(3):241-259.
[17]
Sun L,Jin X,Huang L,et al.Risk of progression in patients with chronic atrophic gastritis:A retrospective study[J].Front Oncol,2022,12:942091.
[18]
Dhingra R, Natov NS, Daaboul Y, et al. Increased Risk of Progression to Gastric Adenocarcinoma in Patients with Nondysplastic Gastric Intestinal Metaplasia Versus a Control Population[J].Dig Dis Sci,2020,65(11):3316-3323.
[19]
Laszkowska M,Truong H,Faye AS,et al.Prevalence of Extensive and Limited Gastric Intestinal Metaplasia and Progression to Dysplasia and Gastric Cancer[J]. Dig Dis Sci,2022,67(8):3693-3701.
[20]
Xie S,Wang S,Xue L,et al. Helicobacter pylori Is Associated With Precancerous and Cancerous Lesions of the Gastric Cardia Mucosa:Results of a Large Population-Based Study in China[J].Front Oncol,2020, Mar 3:10:205.
[21]
Krzysiek-Maczka G,Brzozowski T,Ptak-Belowska A. Helicobacter pylori-activated fibroblasts as a silent partner in gastric cancer development[J].Cancer Metastasis Rev,2023,42(4):1219-1256.
[22]
Liu Y,Cai Y,Chen S,et al. Analysis of Risk Factors of Gastric LowGrade Intraepithelial Neoplasia in Asymptomatic Subjects Undergoing Physical Examination[J]. Gastroenterol Res Pract,2020,2020:7907195.
[23]
The Paris endoscopic classification of superficial neoplastic lesions:esophagus,stomach,and colon:November 30 to December 1,2002 [J]. Gastrointest Endosc,2003,58(Suppl6):S3-43.
[24]
孟曼,令狐恩强,宛东,等. 内镜下氩离子凝固术治疗胃低级别瘤变的临床研究[J/CD]. 中华胃肠内镜电子杂志,2014,1(1):3-7.
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