Correlation Between White Lichenoid Lesion Of Esophageal Mucosa And Positive Margin After Esophageal ESD

Objective:To analyze the clinical,endoscopic and histopathological features of patients with early esophageal cancer and precancerous lesions combined with white lichenoid lesions,to explore the risk factors for positive margins after endoscopic submucosal dissection(ESD),to improve the understanding of early esophageal cancer and precancerous lesions combined with white lichenoid lesions and to guide the application of ESD in clinical decision-making.Methods:The basic information,endoscopic images,postoperative pathology and other basic clinical data of patients with early esophageal cancer and precancerous lesions who underwent ESD from September 2017 to August 2021 and were pathologically diagnosed after surgery were retrospectively collected.A total of 198 patients were included in this study.The patients were divided into white lichenoid lesions group and non-white lichenoid lesions group by endoscopic judgment.The clinical,endoscopic and histopathological characteristics were analyzed for differences.According to the postoperative pathological results,the patients were divided into positive margin negative margin group.The influencing factors related to positive margin were identified by univariate analysis and multivariate logistic regression analysis.Results:119 of 198 patients with early esophageal cancer and precancerous lesions had white lichenoid lesions,which were associated with positive margins after ESD(P=0.032).Thirty-four specimens had positive margins after ESD,and further multivariate analysis revealed that the combination of white lichenoid lesions(P=0.036),cumulative peritubular extent of lesions(>3/4 peritubular weeks,P<0.001),postoperative pathology(whether it was an early esophageal cancer lesion,P=0.002),and depth of lesion invasion(below M3,P<0.001)were independent risk factors for positive margins after ESD in patients with early esophageal cancer and precancerous lesions.Conclusion:Patients with early esophageal cancer and precancerous lesions combined with white lichenoid lesions had an increased risk of positive margins after ESD,and similarly,the cumulative peritubular range of lesions>3/4 peritubular and the depth of lesion invasion were independent risk factors for positive margins.