引用文本：吴文飞, 钟克力. 早期结直肠癌内镜下非治愈性切除术的危险因素和术后处置策略[J/CD]. 消化肿瘤杂志（电子版）, 2025, 17(4): 547-556.

作者：吴文飞1，钟克力2

单位：1. 暨南大学第二临床医学院，深圳市人民医院胃肠外科，广东 深圳 518020；2. 深圳市人民医院（南方科技大学第一附属医院，暨南大学第二临床医学院）胃肠外科，广东 深圳 518000

Authors：Wu Wenfei1，Zhong Keli2

Unit：1. Department of Gastrointestinal Surgery, Shenzhen People's Hospital, the Second Clinical Medical College, Jinan University, Shenzhen 518020, Guangdong, China；2. Department of Gastrointestinal Surgery, Shenzhen People's Hospital (the First Affiliated Hospital, Southern University of Science and Technology; the Second Clinical Medical College, Jinan University), Shenzhen 518020, Guangdong, China

摘要：

尽管早期结直肠癌的内镜整块切除技术可实现临床治愈，但内镜下非治愈性切除（non-curative endoscopic resection, NCER）所带来的切缘阳性、局部复发及淋巴结转移风险，仍是当前临床管理中的核心难题。NCER通常源于切缘不完整（R1/Rx）或存在淋巴结转移的高危病理因素。尽管现行指南将具备任一高危因素的患者归类为高风险并建议追加手术，然而，70%~80%的高风险患者实际淋巴结转移率低于10%，突显了权衡肿瘤学安全与过度治疗风险的决策困境。本文系统梳理了NCER的危险因素及其管理策略，旨在为临床决策的优化提供循证依据。

关键词：早期结直肠癌；非治愈性切除；预后；内镜；补救措施

Abstract：

Although en bloc endoscopic resection techniques for early-stage colorectal cancer can achieve clinical cure, non-curative endoscopic resection (NCER) poses significant challenges due to the risks of margin residue (R1/Rx), local recurrence, and lymph node metastasis. NCER results from incomplete resection margins or the presence of high-risk pathological features associated with lymph node metastasis. Current guidelines classify patients with any high-risk feature as high-risk and recommend additional surgery; however, in 70%-80% of these high-risk patients, the actual lymph node metastasis rate is less than 10%, highlighting the dilemma between ensuring oncologic safety and avoiding overtreatment. This article systematically reviews the risk factors and management strategies for NCER, aiming to provide an evidence-based foundation for optimizing clinical decision-making.

Key words：Early-stage colorectal cancer; Non-curative endoscopic resection; Prognosis; Endoscopy; Salvage therapy

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