早期胃癌淋巴结转移因素分析

目的探讨影响早期胃癌淋巴结转移的因素。方法对74例术后早期胃癌患者的资料,对各临床病理指标与淋巴结转移的关系进行分析,以确定淋巴结转移的危险因素。结果早期胃癌患者的淋巴结转移率为14.9%（11/74）。单因素分析显示黏膜下癌的淋巴结转移率（27.6%）明显高于黏膜内癌（6.7%）（P=0.020）;未分化型癌的淋巴结转移率（27.6%）明显高于分化型（6.8%）（P=0.042）;肿瘤最大径≤2 cm、〉2-4 cm、〉4 cm 3组间淋巴结转移率有统计学意义（χ2=6.549,P=0.038）。采用Log istic回归进行的多因素分析显示,肿瘤最大径（OR=2.688,P=0.047）和浸润深度（OR=4.508,P=0.044）是影响早期胃癌淋巴结转移的独立危险因素。结论早期胃癌淋巴结转移与肿瘤最大径和浸润深度密切相关,这可为手术方案的选择提供参考。

Risk factors of lymph node metastasis in early gastric cancer

Objective To investigate the risk factors of lymph node metastasis in early gastric cancer. Methods The clinicopathological data of 74 cases of early gastric cancer with surgical resection from January 2002 to December 2005 were reviewed. Associations between various clinicopathological factors and the presence of lymph node metastasis were analyzed to identify the risk factors of lymph node metastasis. Results Lymph node metastasis was found in 11 of 74 patients (13.4%). Univariate analysis demonstrated that lymph node metastasis rate in submucosal lesion was significantly higher than that in mucosal lesion (27.6% vs 6.7%,P＝0.020); lymph node metastasis rate in undifferentiated cancer was significantly higher than that in differentiated cancer (27.6% vs 6.8%,P＝0.042). The rate of lymph node metastasis was significantly different among tumors with maximum diameter ≤2 cm,2-4 cm,or ≥4 cm (χ~2 ＝6.549,P＝0.038). By multivariate logistic regression analysis,tumor maximum diameter(OR＝2.688,P＝0.047),mucosal infiltration degree(OR＝4.508,P＝0.044)were identified as independent risk factors of lymph node metastasis. Conclusion Lymph node metastasis in early gastric cancer is closely associated with tumor maximum diameter and mucosal infiltration degree,which provides a reliable reference for the selection of surgical modalities.