探讨同时性多发早期食管癌（EEC）及高级别上皮内瘤变（HGIN）的相关危险因素。

收集自2019年1月至2022年1月在郑州大学第一附属医院行内镜下黏膜剥离术（ESD）治疗的161例早期食管癌及高级别上皮内瘤变病例，其中单发病例137例，同时性多发病例24例，采用t检验或Mann-Whitney U检验，以及χ²检验或Fisher精确概率法，比较2组之间的一般临床资料（年龄、性别、吸烟情况、饮酒情况、高血压、糖尿病、冠心病、腹部手术史及家族消化道肿瘤疾病史等）和病理资料（病变位置、病理类型、浸润深度、内镜分型、病变长径、是否同时存在胃肠上皮化生、糜烂性胃炎等），并采用Logistic回归分析筛选其独立危险因素。

多发病变组患者有更高比例的消化道肿瘤家族史，差异有统计学意义（Z ²=7.149，P=0.008），当患者同时合并胃肠上皮化生时，多发病变发生概率更高（P=0.011）。Logistic回归分析发现，消化道肿瘤家族史（P=0.009，OR=3.592，95%CI：1.375~9.379）以及同时合并的胃肠上皮化生（P=0.010，OR=22.194，95%CI：2.083~236.438）均是多发病变的危险因素，而其他一般临床资料及病变位置等与是否多发无关。

早期食管癌患者有消化道肿瘤家族史及同时合并胃肠上皮化生者易出现多发病灶，建议对存在上述危险因素的患者进行更为细致的内镜下观察及于术后进行细致的内镜评估和密切的随访。

To identify the risk factors for synchronous multiple early esophageal cancer (EEC) and high grade intraepithelial neoplasia (HGIN).

The medical records of patients with synchronous multiple EEC and HGIN for endoscopic submucosal dissection (ESD) at the First Affiliated Hospital of Zhengzhou University from January 2019 to January 2022 were collected. There were 137 single cases and 24 synchronous multiple cases. The t-test or Mann-Whitney U test and the chi-square test or Fisher exact probability test were used to compare the differences in general clinical characteristics (age, gender, smoking, drinking, hypertension, diabetes, coronary heart disease, abdominal operation history, and family history of gastrointestinal cancer) and pathological characteristics (pathological location, pathological type, infiltration depth, endoscopic classification, lesion length and diameter, and whether there were intestinal metaplasia and erosive gastritis) between the two groups. The independent risk factors for synchronous multiple EEC and HGIN were identified by Logistic regression analysis.

Patients with multiple lesions were more likely to have a family history of gastrointestinal tumors (Z ²=7.149, P=0.008). When patients were complicated with gastrointestinal metaplasia at the same time, the probability of multiple lesions was higher (P=0.011). Logistic regression analysis showed that family history of gastrointestinal tumors (P=0.009, odds ratio [OR]=3.592, 95% confidence interval CI: 1.375~9.379) and concurrent gastrointestinal metaplasia (P=0.010, OR=22.194, 95%CI: 2.083~236.438) were risk factors for multiple lesions, while other general clinical data and lesion location were not related to multiple lesions.

Patients with a family history of gastrointestinal tumors and intestinal metaplasia have a higher risk of suffering synchronous multiple EEC and HGIN. It is recommended to conduct more detailed endoscopic observation, careful endoscopic evaluation, and close follow-up after operation.