Objective  To establish a prediction model for non-curative resection in patients with early gastric cancer (EGC) who underwent endoscopic submucosal dissection (ESD), and to evaluate its predictive value.  Methods  Clinical data of EGC patients in the Second Hospital & Clinical Medical School, Lanzhou University from January 2014 to July 2023 were retrospectively collected. According to the postoperative pathological results of ESD, the patients were divided into curative resection group and non-curative resection group. Multifactorial Logistic regression analysis was used to screen the risk factors for non-curative resection after ESD surgery and establish a prediction model, and the model was evaluated using receiver operating characteristic(ROC) curves, calibration curves and clinical decision curve analysis.  Results  A total of 479 EGC patients who underwent ESD were included, with 60 cases in the non-curative resection group and 419 cases in the curative resection group. The results of multifactorial Logistic regression analysis showed that the lesion diameter > 2 cm (OR=3.017, 95% CI: 1.483-6.136, P=0.002), flat lesion morphology (OR=2.712, 95% CI: 0.774-9.497, P=0.043), undifferentiated/mixed histologic type (OR= 4.199, 95% CI: 1.621-10.872, P=0.003), and submucosal infiltration (OR=30.329, 95% CI: 13.059-70.436, P < 0.001) were independent risk factors for non-curative resection after ESD in EGC patients. The area under the curve of ROC validated within the column-line graph prediction model constructed accordingly was 0.867 (95% CI: 0.811-0.923), the calibration curve showed that the model had good calibration, and decision curve analysis showed the model had a good clinical usefulness.  Conclusions  The prediction model constructed based on lesion diameter, lesion morphology, histologic type, and depth of mucosal infiltration has good differentiation, calibration, and clinical utility. This model is expected to assist in the early clinical screening of the population at high risk for noncurative resection after ESD in patients with EGC, and to provide a basis for the development of optimal clinical decisions.

Objective To explore the risk factors for postoperative pathologic upgrading after endoscopic submucosal dissection(ESD)in patients with endoscopic biopsy diagnosis of gastric low-grade intraepithelial neoplasia(LGIN).Methods The clinicopatho-logical data of patients who underwent ESD at the Second Hospital of Lanzhou University between January 2013 and July 2023 and were di-agnosed with LGIN by preoperative endoscopic biopsy pathology were retrospectively analyzed.The patients were divided into the upgraded group(83 cases)and the un-upgraded group(61 cases)according to the pathological findings after ESD,and the risk factors for patho-logical upgrading of LGIN were explored using univariate and multivariate Logistic regression analyses.Results A total of 144 patients were included;61 lesions remained LGIN after ESD,37 were upgraded to high-grade intraepithelial neoplasia(HGIN),and 46 were upgraded to early gastric cancer(EGC).The pathologic upgrade rate of endoscopic biopsy of LGIN was 57.6％.Comparison of lesion size,spontaneous bleeding,and irregular microvascular pattern(IMVP)between the two groups showed statistically significant differences(P＜0.05);however,no statistically significant difference between the two groups was observed for gender,age,surface redness,sur-face nodules,surface ulcers,site,and morphology(P＞0.05).The results of multivariate Logistic regression analysis showed that lesion size ≥2cm(P=0.006)and IMVP(+)(P=0.027)were independent risk factors for pathologic upgrade after ESD in LGIN patients.Conclusion The consistency between endoscopic biopsy diagnosis of LGIN and postoperative pathologic diagnosis of ESD was poor,and biopsy could not be used as its final diagnosis;patients with LGIN whose lesion size was ≥2cm and IM VP(+)should be alerted to the possibility of pathological upgraded,and it was recommended that ESD be performed to remove the lesion.

Objective To explore the risk factors for postoperative pathologic upgrading after endoscopic submucosal dissection(ESD)in patients with endoscopic biopsy diagnosis of gastric low-grade intraepithelial neoplasia(LGIN).Methods The clinicopatho-logical data of patients who underwent ESD at the Second Hospital of Lanzhou University between January 2013 and July 2023 and were di-agnosed with LGIN by preoperative endoscopic biopsy pathology were retrospectively analyzed.The patients were divided into the upgraded group(83 cases)and the un-upgraded group(61 cases)according to the pathological findings after ESD,and the risk factors for patho-logical upgrading of LGIN were explored using univariate and multivariate Logistic regression analyses.Results A total of 144 patients were included;61 lesions remained LGIN after ESD,37 were upgraded to high-grade intraepithelial neoplasia(HGIN),and 46 were upgraded to early gastric cancer(EGC).The pathologic upgrade rate of endoscopic biopsy of LGIN was 57.6％.Comparison of lesion size,spontaneous bleeding,and irregular microvascular pattern(IMVP)between the two groups showed statistically significant differences(P＜0.05);however,no statistically significant difference between the two groups was observed for gender,age,surface redness,sur-face nodules,surface ulcers,site,and morphology(P＞0.05).The results of multivariate Logistic regression analysis showed that lesion size ≥2cm(P=0.006)and IMVP(+)(P=0.027)were independent risk factors for pathologic upgrade after ESD in LGIN patients.Conclusion The consistency between endoscopic biopsy diagnosis of LGIN and postoperative pathologic diagnosis of ESD was poor,and biopsy could not be used as its final diagnosis;patients with LGIN whose lesion size was ≥2cm and IM VP(+)should be alerted to the possibility of pathological upgraded,and it was recommended that ESD be performed to remove the lesion.

Objective:To evaluate radiofrequency ablation-assisted liver resection on early recurrence of hepatocellular carcinoma(HCC) with microvascular invasion (MVI).Methods:A total of 82 HCC patients from Jun 2015 to Jun 2020 were divided into assisted group ( n=41) and control group ( n=41) after local hepatectomy.And by pathology,both groups were further substratified into with or without MVI subgroups. Results:There was no statistically significant difference in the baseline data between two groups,nor there was difference in recurrence-free survival rate between the two groups ( χ 2=0.177, P=0.674). However, by subgroup analysis, the recurrence-free survival rate of ablation assisted group was higher than that of the simple local hepatectomy group among MVI positive patients ( χ 2=5.096, P = 0.024).Multivariate analysis showed that only tumor diameter ( HR=1.32, 95% CI: 1.02-1.72, P=0.036) was an independent risk factor for local recurrence at the incisal margin, while mode of operation ( HR=0.15 ,95% CI: 0.04-0.52 ,P=0.003) and MVI ( HR=8.65 ,95% CI: 2.19-34.19 ,P=0.002) were independent risk factors for intrahepatic distant metastasis. Conclusion:Local hepatectomy assisted by intraoperative radiofrequency ablation on hepatic cross section could effectively reduce the postoperative early recurrence rate for hepatocellular carcinoma patients with MVI.