Analysis of factors influencing the incomplete resection of rectal neuroendocrine tumor and positive vertical margin of specimen after ESD

ObjectiveTo analyze the factors influencing the incomplete resection of rectal neuroendocrine tumor patients after endoscopic submucosal dissection(ESD) and the the positive vertical margin of the specimen.

MethodsOne hundred and twenty-five patients with rectal neuroendocrine tumors were selected as the research objects.All of them underwent ESD treatment.According to the effect of surgical treatment, they were divided into the complete resection group(n=89) and the incomplete resection group(n=36).Among them, 15 cases of specimens in the incomplete resection group had positive vertical margins.Binary logistic regression was used to analyze the related factors that affect incomplete resection after ESD affecting the positive vertical margin and the positive vertical resection margin of the specimen.

ResultsThe univariate analysis of incomplete resection after ESD showed that gender, age, and bulge shape were not significantly correlated with incomplete resection after ESD(P>0.05).Tumor diameter, depth of infiltration, central depression on the surface of the lesion and ESD after operation incomplete resection was significantly correlated with incomplete resection after ESD(P<0.01).Binary logistic regression analysis showed that tumor diameter>1.5 cm/1-1.5 cm, infiltration depth of submucosa, and central mucosa on the surface of the lesion were independent risk factors affecting incomplete resection after ESD(P<0.05).A univariate analysis of the positive vertical margin of the specimen showed that gender, age, and swelling shape were not significantly correlated with the positive vertical margin of the specimen(P>0.05).The lesion diameter, lesion shape, mitotic image were significantly related to the positive vertical margin of the specimen(P<0.05).Binary logistic regression analysis showed that tumor diameter>1.5 cm/1-1.5 cm, infiltration depth of submucosa and central mucosa on the surface of the lesion was independent risk factors affected the incomplete resection after ESD(P<0.05).

ConclusionsTumor diameter>1.5 cm, infiltration into the submucosa, central depression on the surface of the lesion and positive vertical margins of the specimen indicate that patients with rectal neuroendocrine tumors have the higher risk of incomplete resection after ESD treatment.Lesions diameter ≥10 mm indicates that there is a high risk of positive vertical margins after ESD treatment.The clinical evaluation and follow-up should be strengthened to provide reference for the subsequent treatment.