Tengfei Li1, Pengfei Liu Bin Xiang. 1. Department of Gastroenterology, The Affiliated Jiangyin Hospital of Southeast University Medical School, Jiangyin, China.
Abstract
PURPOSE: To study the clinical effect of endoscopic mucosal resection (EMR) in the treatment of early gastric cancer (EGC), and to evaluate the recovery and prognosis, so as to provide references for clinical selection of treatment methods. METHODS:120 patients with EGC were selected and randomly divided into the EMR group and the radical surgery group. Before surgery and 3 days after surgery, the levels of traumatic response-related indexes in serum [adrenocorticotropic hormone (ACTH), cortisol (Cor), gastrin (GAS) and motilin (MTL)] were assessed. Before surgery, 3 months and 1 year after surgery, the expression levels of tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 19.9 (CA19.9), CA125 and CA724] were assessed. Before surgery and 3 days and 3 months after surgery, the immune function indexes [cluster of differentiation (CD)25+, CD28+ and inducible costimulator (ICOS)] were measured. Moreover, the clinical effect of surgery and the incidence rate of complications were compared between the two groups, and patients were followed up for at least 2 years to evaluate their prognosis. RESULTS: The clinical cure rate of tumor resection was comparable in both groups, and the incidence rate of complications in the EMR group was significantly lower than that in the radical surgery group (p<0.05). The levels of tumor markers were significantly increased compared with those before surgery in both groups (p<0.05), but without significant differences between the two groups. Three days after surgery in the radical surgery group, ACTH and Cor were increased, while GAS and MTL were decreased, and the levels of immune indexes declined (p<0.05). In the EMR group, the above indexes had no significant differences compared with those before surgery. Three days after surgery, the survival and recurrence rate in the EMR group and the radical surgery group were 95.0% vs. 98.3% and 5.0% vs. 3.3%, respectively (p>0.05). CONCLUSIONS: The treatment of EGC with EMR has comparable clinical effect and prognosis to the traditional radical surgery, which causes less damage to the body and gastrointestinal function and less inhibition on the immune function, so it is worthy of clinical application.
RCT Entities:
PURPOSE: To study the clinical effect of endoscopic mucosal resection (EMR) in the treatment of early gastric cancer (EGC), and to evaluate the recovery and prognosis, so as to provide references for clinical selection of treatment methods. METHODS: 120 patients with EGC were selected and randomly divided into the EMR group and the radical surgery group. Before surgery and 3 days after surgery, the levels of traumatic response-related indexes in serum [adrenocorticotropic hormone (ACTH), cortisol (Cor), gastrin (GAS) and motilin (MTL)] were assessed. Before surgery, 3 months and 1 year after surgery, the expression levels of tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 19.9 (CA19.9), CA125 and CA724] were assessed. Before surgery and 3 days and 3 months after surgery, the immune function indexes [cluster of differentiation (CD)25+, CD28+ and inducible costimulator (ICOS)] were measured. Moreover, the clinical effect of surgery and the incidence rate of complications were compared between the two groups, and patients were followed up for at least 2 years to evaluate their prognosis. RESULTS: The clinical cure rate of tumor resection was comparable in both groups, and the incidence rate of complications in the EMR group was significantly lower than that in the radical surgery group (p<0.05). The levels of tumor markers were significantly increased compared with those before surgery in both groups (p<0.05), but without significant differences between the two groups. Three days after surgery in the radical surgery group, ACTH and Cor were increased, while GAS and MTL were decreased, and the levels of immune indexes declined (p<0.05). In the EMR group, the above indexes had no significant differences compared with those before surgery. Three days after surgery, the survival and recurrence rate in the EMR group and the radical surgery group were 95.0% vs. 98.3% and 5.0% vs. 3.3%, respectively (p>0.05). CONCLUSIONS: The treatment of EGC with EMR has comparable clinical effect and prognosis to the traditional radical surgery, which causes less damage to the body and gastrointestinal function and less inhibition on the immune function, so it is worthy of clinical application.
Authors: Bo-Xiang Qi; Lei Zhu; Li-Ping Sheng; Na-Na Wen; Xiao Cheng; Shuang-Shuang Hu; Tong Qian Journal: Zhongguo Dang Dai Er Ke Za Zhi Date: 2022-07-15