胃癌淋巴结转移影响因素临床分析

背景:胃癌是常见的消化道恶性肿瘤,淋巴结转移是其最主要的转移方式,亦是影响根治性切除术后胃癌患者预后的重要因素。目的:探讨胃癌淋巴结转移与患者临床病理特点之间的相关性。方法:对2007年1月～2008年1月在浙江省诸暨市人民医院行胃癌根治术的72例病例行回顾性分析,总结其临床病理特点。结果:性别、年龄和肿瘤部位与胃癌淋巴结转移均不相关(P0.05);胃癌的TNM分期越晚,淋巴结转移率越高(P0.01);脉管内有癌栓者的淋巴结转移率显著高于脉管内无癌栓者(84.2%对52.8%,P0.05):肿瘤浸润浆膜和浆膜外者的淋巴结转移率显著高于肿瘤浸润浆膜以内者(86.4%对28.6%,P0.01);低分化胃癌的淋巴结转移率显著高于高中分化胃癌(75.0%对39.3%,P0.01)。多因素Logistic回归分析显示,TNM分期和肿瘤浸润深度是胃癌淋巴结转移的危险因素,RR分别为9.000和9.335。结论:肿瘤的TNM分期和浸润深度是影响胃癌淋巴结转移的主要因素。

Clinical Analysis of Influencial Factors on Lymph Node Metastasis of Gastric Cancer

Background： Gastric cancer is one of the most common gastrointestinal malignant tumors and lymph node metastasis is the most important route of metastasis. This key factor may influence the prognosis of postoperative gastric cancer patients. Aims： To appraise the relationship between clinicopathologic characteristics and lymph node metastasis in gastric cancer patients. Methods： The clinicopathologic characteristics of 72 gastric cancer patients receiving radical excision in Zhuji People＇s Hospital from January 2007 to January 2008 were retrospectively analyzed. Results： It was found that gender, age, and tumor site were not correlated with lymph node metastasis of gastric cancer （P〉0.05）. The more advanced the TNM staging was, the higher the lymph node metastasis rate was （P〈0.01）. The lymph node metastasis rate in those with vascular tumor emboli was much higher than those without vascular tumor emboli （84.2% vs. 52.8%, P〈 0.05）; Those with infiltration beyond serosa had significantly higher lymph node metastasis rate than those without infiltration beyond serosa （86.4% vs. 28.6%, P〈0.01）. Poorly differentiated tumors had higher lymph node metastasis rate than moderate and well differentiated ones （75.0% vs. 39.3% P〈0.01）. Logistic analysis revealed that TNM staging and depth of invasion represented risk factors for lymph node metastasis of gastric cancer, with RR of 9.000 and 9.335, respectively. Conclusions： TNM staging and depth of invasion are the main factors that affecting lymph node metastasis in patients with gastric cancer.