Prediction of risk factors for lymph node metastasis in early gastric cancer

查看全文 作　　者：Gang [1]Ren;Rong [2]Cai;Wen-Jie [3]Zhang;Jin-Ming [3]Ou;Ye-Ning [2]Jin;Wen-Hua [1]Li

机构地区：[1]Department of Radiology,Xinhua Hospital,Shanghai Jiaotong University Medical School;[2]Department of Radiochemotherapy,Ruijin Hospital,Shanghai Jiaotong University Medical School;[3]Department of Surgery,Xinhua Hospital,Shanghai Jiaotong University Medical School

出　　处：《World Journal of Gastroenterology》索引2013年第19卷第20期,共12页

基　　金：Supported by Shanghai Jiaotong University Medical School for Scientific Research,No.09XJ21013;Shanghai Health Bureau for Scientific Research,No.2010029;Shanghai Science and Technology Commission for Scientific Research,No.124119a0300 摘　　要：AIM:To explore risk factors for lymph node metastases in early gastric cancer(EGC) and to confirm the appropriate range of lymph node dissection.METHODS:A total of 202 patients with EGC who underwent curative gastrectomy with lymphadenectomy in the Department of Surgery,Xinhua Hospital and Ruijin Hospital of Shanghai Jiaotong University Medical School between November 2003 and July 2009,were retrospectively reviewed.Both the surgical procedure and the extent of lymph node dissection were based on the recommendations of the Japanese gastric cancer treatment guidelines.The macroscopic type was classified as elevated(type Ⅰ or Ⅱa),flat(Ⅱb),or depressed(Ⅱc or Ⅲ).Histopathologically,papillary and tubular adenocarcinomas were grouped together as differentiated adenocarcinomas,and poorly differentiated and signet-ring cell adenocarcinomas were regarded as undifferentiated adenocarcinomas.Univariate and multivariate analyses of lymph node metastases and patient and tumor characteristics were undertaken.RESULTS:The lymph node metastases rate in patients with EGC was 14.4%.Among these,the rate for mucosal cancer was 5.4%,and 8.9% for submucosal cancer.Univariate analysis showed an obvious correlation between lymph node metastases and tumor location,depth of invasion,morphological classification and venous invasion(χ 2 = 122.901,P = 0.001;χ 2 = 7.14,P = 0.008;χ 2 = 79.523,P = 0.001;χ 2 = 8.687,P = 0.003,respectively).In patients with submucosal cancers,the lymph node metastases rate in patients with venous invasion(60%,3/5) was higher than in those without invasion(20%,15/75)(χ 2 = 4.301,P = 0.038).Multivariate logistic regression analysis revealed that the depth of invasion was the only independent risk factor for lymph node metastases in EGC [P = 0.018,Exp(B) = 2.744].Among the patients with lymph node metastases,29 cases(14.4%) were at N1,seven cases were at N2(3.5%),and two cases were at N3(1.0%).Univariate analysis of variance revealed a close relationship between the depth of invasion and lymph node metastases at pN 1(P = 0.008).CONCLUSION:The depth of invasion was the only independent risk factor for lymph node metastases.Risk factors for metastases should be considered when choosing surgery for EGC. 关键词：GASTRIC NEOPLASM LYMPH NODE metastasis Risk factors GASTRECTOMY LYMPHADENECTOMY

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Prediction of risk factors for lymph node metastasis in early gastric cancer

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