内镜下黏膜切除术与黏膜剥离术治疗结直肠神经内分泌瘤的临床疗效及淋巴结转移的高危因素分析

doi:10.3760/cma.j.issn.115807-20190911-00177

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题名	内镜下黏膜切除术与黏膜剥离术治疗结直肠神经内分泌瘤的临床疗效及淋巴结转移的高危因素分析
其他题名	Clinical efficacy of ESD and EMR in treatment of colorectal neuroendocrine tumors and analysis of high risk factors for postoperative lymph node metastasis
作者	郑艳艳 1; 金照 1; 潘逸迁 1; 黄崇杰2
发表日期	2020
发表期刊	中华内分泌外科杂志影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	内镜下黏膜切除术内镜下黏膜剥离术结直肠神经内分泌瘤淋巴结转移
其他关键词	Endoscopic mucosal resection ; Endoscopic mucosal dissection ; Colorectal neuroendocrine tumor ; Lymph node metastasis
摘要	目的探究内镜下黏膜切除术(endoscopic mucosal resecfion, EMR)与内镜下黏膜剥离术(endoscopic submucosal dissection, ESD)治疗结直肠神经内分泌瘤(neuroendocrine tumors, NET)的临床疗效及淋巴结转移的高危因素。方法回顾性分析2010年1月至2014年1月温州市中西医结合医院收治的148例结直肠NET患者的临床资料,根据治疗方案的不同将148例结直肠NET患者分为EMR组(n=72)和ESD组(n=76),EMR组行EMR治疗,ESD组行ESD治疗,比较两组手术情况、并发症发生情况,单因素和多因素Logistic回归分析结直肠NET患者术后淋巴结转移的影响因素。结果 ESD组手术时间、手术费用、整块切除率、组织学完全切除率显著高于EMR组[(28.28±8.05)vs(15.77±6.41)min;(5699.13±351.61)vs(2205.71±123.47)yuan; 76% vs 65%; 73% vs 62%;P<05];ESD组术后出血、穿孔发生率略高于EMR组(P>0.05);年龄、性别不同的结直肠NET患者术后淋巴结转移情况差异无统计学意义(P>0.05);浸润深度、淋巴管浸润、WHO分级、手术方案不同的结直肠NET患者,两组术后淋巴结转移情况差异有统计学意义(P<0.05);淋巴管浸润、手术方案是影响结直肠NET患者术后淋巴结转移的危险因素(P<0.05)。结论 ESD治疗结直肠NET的手术整块切除率和组织学完全切除率较EMR高,术后并发症及淋巴结转移发生率较EMR低;淋巴管浸润、手术方案为EMR的结直肠NET患者术后易发生淋巴结转移。ESD可作为临床治疗结直肠NET的首选方案,以提升结直肠NET患者预后。
其他摘要	Objective:To investigate the clinical efficacy of endoscopic mucosal resection (EMR) and endoscopic mucosal dissection (ESD) in the treatment of colorectal neuroendocrine tumors and analysis of high risk factors for postoperative lymph node metastasis.Methods:Clinical data of 148 patients with colorectal neuroendocrine tumor admitted to Wenzhou integrated traditional Chinese and Western Medicine Hospital from Jan.2010 to Jan.2014 were retrospectively analyzed. Patients were divided into EMR group ( n=72) and ESD group ( n=76) according to different treatment regimens. The operation status and complications of the two groups were compared. Univariate and multivariate Logistic regression analysis were used to determine the influencing factors of postoperative lymph node metastasis in patients with rectal neuroendocrine tumor. Results:The operation time, operation cost, whole resection rate, and histological complete resection rate in ESD group were significantly higher than those in EMR group[ (28.28±8.05) vs (15.77±6.41) min; (5699.13±351.61) vs (2205.71±123.47) yuan; 76% vs 65%; 73% vs 62%; P<05]. The incidence of postoperative bleeding and perforation in ESD group was slightly higher than that in EMR group, with no statistic difference ( P0.05) . The incidence rate of postoperative lymph node metastasis showed no difference among patients with different ages and genders ( P0.05) , while had statistic difference among patients with different infiltration depth, lymphatic infiltration, WHO grade, surgery methods ( P<0.05) . Lymphatic infiltration and surgical methods were the influencing factors of postoperative lymph node metastasis in patients with colorectal neuroendocrine tumor ( P<0.05) . Conclusions:Compared with EMR, ESD in treatment of colorectal neuroendocrine tumors has a higher rate of total resection and histological resection, and a lower incidence rate of complications and lymph node metastasis. Patients with lymphatic vessel infiltration, and inappropriate surgical procedure have high risk of postoperative lymph node metastasis. ESD is worthy of promotion.
资助项目	温州市基础性科研项目（2019Y1178）
ISSN	1674-6090
卷号	14 期号:06 页码:461-465
DOI	10.3760/cma.j.issn.115807-20190911-00177
页数	5
收录类别	CNKI ; 万方 ; SCOPUS ; 维普 ; ISTIC
URL	查看原文
SCOPUSEID	2-s2.0-85152421792
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/54089
专题	第二临床医学院，附属第二医院、育英儿童医院_外科学_肛肠外科
作者单位	1.温州市中西医结合医院肛肠外科; 2.温州医科大学附属第二医院肛肠外科
推荐引用方式 GB/T 7714	郑艳艳,金照,潘逸迁,等. 内镜下黏膜切除术与黏膜剥离术治疗结直肠神经内分泌瘤的临床疗效及淋巴结转移的高危因素分析[J]. 中华内分泌外科杂志,2020,14(06):461-465.
APA	郑艳艳, 金照, 潘逸迁, & 黄崇杰. (2020). 内镜下黏膜切除术与黏膜剥离术治疗结直肠神经内分泌瘤的临床疗效及淋巴结转移的高危因素分析. 中华内分泌外科杂志, 14(06), 461-465.
MLA	郑艳艳,et al."内镜下黏膜切除术与黏膜剥离术治疗结直肠神经内分泌瘤的临床疗效及淋巴结转移的高危因素分析".中华内分泌外科杂志 14.06(2020):461-465.