Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2022; 14(3): 724-733
Published online Mar 15, 2022. doi: 10.4251/wjgo.v14.i3.724
Clinical efficacy and prognostic risk factors of endoscopic radiofrequency ablation for gastric low-grade intraepithelial neoplasia
Nan-Jun Wang, Ning-Li Chai, Xiao-Wei Tang, Long-Song Li, Wen-Gang Zhang, En-Qiang Linghu
Nan-Jun Wang, Ning-Li Chai, Xiao-Wei Tang, Long-Song Li, Wen-Gang Zhang, En-Qiang Linghu, Department of Gastroenterology and Hepatology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Wang NJ and Chai NL are co-first authors and contributed equally to this work; Wang NJ and Chai NL designed and performed the research and wrote the paper; Tang XW designed the research and supervised the report; Li LS designed the research and contributed to the analysis; Zhang WG supervised the report; Linghu EQ designed the research and provided clinical advice.
Supported by National Key R&D Program of China, No. 2016YFC1303601.
Institutional review board statement: The Medical Ethics Committee of the PLA General Hospital agreed to exempt this study from medical ethics review.
Informed consent statement: All patients have signed informed consent forms.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: En-Qiang Linghu, MD, PhD, Chief Doctor, Chief Physician, Director, Professor, Department of Gastroenterology and Hepatology, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. linghuenqiang@vip.sina.com
Received: November 1, 2021
Peer-review started: November 1, 2021
First decision: December 2, 2021
Revised: December 15, 2021
Accepted: February 27, 2022
Article in press: February 27, 2022
Published online: March 15, 2022
Processing time: 129 Days and 0.4 Hours
Abstract
BACKGROUND

The use of radiofrequency ablation (RFA) has been reported in the treatment of gastric low-grade intraepithelial neoplasia (LGIN). However, its efficacy and prognostic risk factors have not been well analyzed.

AIM

To explore the efficacy and prognostic risk factors of RFA for gastric LGIN in a large, long-term follow-up clinical study.

METHODS

The clinical data of 271 consecutive cases from 198 patients who received RFA for treatment of gastric LGIN at the Chinese PLA General Hospital from October 2014 to October 2020 were reviewed in this retrospective study. Data on operative parameters, complications, and follow-up outcomes including curative rates were recorded and analyzed.

RESULTS

The curative rates of endoscopic RFA for gastric LGIN at 3 mo, 6 mo, and 1-5 years after the operation were 93.3%, 92.8%, 91.5%, 90.3%, 88.5%, 85.7%, and 83.3%, respectively. Multivariate analyses revealed that Helicobacter pylori (H. pylori) infection and disease duration > 1 year had a significant effect on the curative rate (P < 0.001 and P = 0.013, respectively). None of patients had bleeding, perforation, infection, or other serious complications after RFA, and the main discomfort was postoperative abdominal pain.

CONCLUSION

RFA was safe and effective for gastric LGIN during long-term follow-up. H. pylori infection and disease course > 1 year may be the main risk factors for relapse of LGIN after RFA.

Keywords: Endoscopic radiofrequency ablation; Gastric low-grade intraepithelial neoplasia; Clinical efficacy; Prognostic risk factors

Core Tip: This is a retrospective study to explore the efficacy and prognostic risk factors of radiofrequency ablation (RFA) for gastric low-grade intraepithelial neoplasia (LGIN). The curative rates of endoscopic RFA for gastric LGIN at 3 mo, 6 mo, and 1-5 years after the operation were 93.3%, 92.8%, 91.5%, 90.3%, 88.5%, 85.7%, and 83.3%, respectively. Multivariate analyses revealed that Helicobacter pylori infection and disease duration > 1 year had a significant effect on the curative rate. No serious complications occurred after RFA in all 198 patients. RFA was safe and effective for gastric LGIN during long-term follow-up.