不同研究中浅表食管鳞状细胞癌（ESCC）内镜切除（ER）后复发的风险和病理因素不一致。我们通过系统评价和荟萃分析对此进行了评估。此类患者的复发数据是从所有研究中提取的。使用随机效应荟萃分析组合风险比（RR），以评估汇总复发率和病理危险因素。采用Kaplan-Meier法结合无复发生存期来估计各种病理因素与复发时间之间的关系。我们筛选了26项研究，总共5100名患者，其中321名复发患者（汇总率为6.2%）。垂直切缘 (VM) 阳性 (RR [95% CI]: 4.51 [2.16 - 9.44])、水平切缘 (HM) 阳性 (RR [95% CI]: 2.54 [1.57 - 4.13]) 的复发风险显着较高）、淋巴管侵犯（LVI）（RR [95% CI]：2.33 [1.75 - 3.11]，P < 0.001）、淋巴管侵犯（LI）（RR [95% CI]：2.24 [1.24 - 4.06]）和肿瘤侵入粘膜下层≤200 μm (SM1)（与粘膜肌层相比，RR [95% CI]：1.71 [1.32 - 2.21]）。 LI（HR 2.47；95% CI 1.24 - 4.90；P = 0.02）和LVI（HR 2.36；95% CI 2.22 - 4.59；P = 0.0006）患者在ER后往往较早复发。浅表ESCC术后复发率急诊室是可以接受的。切缘、LVI、LI 和 SM1 阳性的患者需要高度关注复发风险。 LI和VI应分别评估。 (PROSPERO CRD42023406309)。版权所有 © 2024 美国胃肠内窥镜协会。由爱思唯尔公司出版。保留所有权利。

The risk and pathological factors of recurrence after endoscopic resection (ER) for superficial esophageal squamous cell carcinoma (ESCC) are inconsistent across studies. We evaluated this in a systematic review and meta-analysis.The data of recurrence in such patients was extracted from all studies. Risk ratios (RRs) were combined using random-effects meta-analysis, to assess pooled recurrence rate and pathological risk factors. Relapse-free survival was combined using the Kaplan-Meier method to estimate the relationship between various pathological factors and recurrence time.We identified 26 studies, with a total of 5100 patients and 321 with recurrences (pooled rate, 6.2%). The risk of recurrence was significantly higher in positive vertical margin (VM) (RR [95% CI]: 4.51 [2.16 - 9.44]), positive horizontal margin (HM) (RR [95% CI]: 2.54 [1.57 - 4.13]), lymphovascular invasion (LVI) (RR [95% CI]: 2.33 [1.75 - 3.11], P < 0.001), lymphatic invasion (LI) (RR [95% CI]: 2.24 [1.24 - 4.06]), and tumor invading submucosa ≤200 μm (SM1) (RR [95% CI]: 1.71 [1.32 - 2.21], compared to muscularis mucosa). Patients with LI (HR 2.47; 95% CI 1.24 - 4.90; P = 0.02) and LVI (HR 2.36; 95% CI 2.22 - 4.59; P = 0.0006) tended to have earlier recurrence after ER.The recurrence rate of superficial ESCC after ER is acceptable. Patients with positive margins, LVI, LI and SM1 need to pay significant attention to the risk of recurrence. LI and VI should be evaluate separately. (PROSPERO CRD42023406309).Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.