食管癌淋巴结转移的危险因素分析

目的探讨食管癌淋巴结转移的危险因素。 方法回顾性分析2015年7月至2017年9月,新疆自治区人民医院胸外科行手术治疗食管癌的224例患者的病例资料,比较淋巴结转移组(转移组)与非淋巴结转移组(非转移组)的关系,并进行多因素Logistic回归进行分析,探讨淋巴结转移的危险因素。 结果患者症状期较长、肿瘤长度、分化程度、肿瘤分期T与淋巴结转移有显著相关性(P<0.05)。 结论肿瘤低分化、肿瘤长度>5 cm、肿瘤侵润深度T₃～T₄、患者症状期>6个月是淋巴结转移的危险因素,应尽可能选择经右胸入路胸腹腔镜辅助下食管癌根治术,并清扫双侧喉返神经淋巴结。     

早期浸润性乳腺癌患者腋窝淋巴结转移的影响因素分析

目的 探讨早期浸润性乳腺癌患者腋窝淋巴结转移的影响因素.方法 收集350例早期浸润性乳腺癌患者的临床病理资料及MRI特征资料,根据临床病理检查结果将其分为腋窝淋巴结转移组(120例)和腋窝淋巴结未转移组(230例).比较两组临床病理资料及MRI特征资料,并采用多元Logistic回归分析法分析早期浸润性乳腺癌患者发生腋...     

早期胃癌淋巴结转移影响因素分析

背景：手术是早期胃癌的首选治疗方法。淋巴结转移是早期胃癌的关键预后因素,术中淋巴结清扫虽可降低术后复发率,但清扫过度可能导致患者术后生活质量降低。目的：分析早期胃癌淋巴结转移的独立危险因素。方法：1982年1月～2009年2月于上海市长宁区中心医院行胃癌根治术且淋巴结清扫〉15枚的376例早期胃癌患者纳入研究,分析性别、年龄以及6项肿瘤临床病理特征与淋巴结转移之间的关系。结果：单因素分析显示．肿瘤≥2cm、大体类型为隆起型、黏膜下浸润、分化差和有淋巴管癌栓与早期胃癌淋巴结转移有关,而性别、年龄和肿瘤部位与淋巴结转移之间无明显相关性。多因素logistic回归显示肿瘤大小、浸润深度和分化程度是早期胃癌淋巴结转移的独立危险因素。结论：临床医师术前可通过内镜超声、CT和活检病理检查确定早期胃癌的淋巴结肿大情况以及肿瘤大小、浸润深度和组织学类型．据此推测有无淋巴结转移倾向．从而选择合理的手术方式和术中淋巴结清扫范围。     

早期胃癌淋巴结转移的危险因素及MDCT评估

目的:分析早期胃癌(early gastric careinoma,EGC)淋巴结转移的危险因素并探讨多排CT(multidetector-row CT,MDCT)对淋巴结转移术前评估的价值.方法:术前行MDCT检查并行根治性胃切除术的EGC患者109例,男64例,女45例,平均年龄56岁,分析患者的临床病理因素与其淋巴结转移的关系,并将MDCT对淋巴结状况的评估结果与病理结果相对照.结果:EGC患者的淋巴结转移率为15.60%,其中黏膜下癌的淋巴结转移率明显高于黏膜内癌(25.00% vs 9.23%,P=0.026).EGC淋巴结转移与患者性别、年龄、肿瘤大小、大体类型、肿瘤位置和组织学类型均无关.受试者工作特征(receiver operating characteristic,ROC)分析进一步显示EGC肿瘤大小对淋巴结转移判断的价值相对较小(曲线下面积为0.63).MDCT对早期胃癌N分期的判断准确率为82.6%,其中N0为85.9%,N1为64.3%,N2为66.7%.MDCT对EGC淋巴结转移判断的敏感度、特异度和准确率分别为70.6%、85.9%和83.5%.MDCT对单发淋巴结转移患者判断的敏感度为50.0%,对1枚以上淋巴结转移患者判断的敏感度为88.9%.MDCT未检出转移淋巴结的EGC患者5例的肿瘤均大于或等于2cm,其中2例黏膜内癌均为凹陷型.结论:MDCT对EGC淋巴结转移术前评估有较大的临床应用价值,对EGC患者实施微创治疗时,应重视淋巴结转移相关临床病理因素的评估作用.     

早期胃癌淋巴结转移危险因素预测模型的研究进展

内镜技术的发展使早期胃癌的诊断率不断提高,而有无淋巴结转移显著影响治疗方式的选择以及患者预后。本文介绍早期胃癌淋巴结转移危险因素预测模型的研究进展,并比较各类模型之间的区分度及临床易用程度,旨在为临床医师选择最佳治疗方案提供参考。     

分化不良型早期胃癌淋巴结转移的危险因素分析

目的评估分化不良型早期胃癌患者淋巴结转移的危险因素,探讨其内镜治疗的可能性。方法回顾性分析2002年9月-2008年12月经手术证实的100例分化不良型早期胃癌患者,对其年龄、性别、肿瘤大小、部位、大体类型、溃疡、组织学类型、浸润深度及淋巴管肿瘤浸润与淋巴结转移的关系进行单因素和多因素分析。结果分化不良型早期胃癌的淋巴结转移率达18．00％。多变量分析显示肿瘤大小（〉2cm）、侵犯至黏膜下层、淋巴管肿瘤浸润均是分化不良型早期胃癌淋巴结转移的独立危险因素（P〈0．05）。肿瘤大小和淋巴管肿瘤浸润是分化不良型黏膜内早期胃癌的淋巴结转移的独立危险因素。在直径≤2cm且无淋巴管肿瘤浸润的分化不良型黏膜内早期胃癌中未发现淋巴结转移。结论直径≤2cm且无淋巴管肿瘤浸润的分化不良型黏膜内癌患者可考虑内镜治疗,术后需密切随访。     

早期胃癌淋巴结转移规律及其影响因素分析

目的 探讨早期胃癌淋巴结转移规律及其影响因素,为选择合适的治疗方法提供依据.方法 对北京大学第三医院1988年3月-2009年3月于外科行胃癌根治术治疗的103例早期胃癌患者临床资料进行回顾性研究,对患者的年龄、性别,肿瘤的大小、部位、大体类型、分化程度及浸润深度与淋巴结转移的关系进行单因素及多因素分析.结果 早期胃癌的淋巴结转移率为17.5%(18/103),其中黏膜内癌的淋巴结转移率为4.1%(2/49),黏膜下层癌的淋巴结转移率为29.6%(16/54).logistic回归分析显示,浸润至黏膜下层(P=0.001)及肿瘤>2 cm(P=0.003)为早期胃癌淋巴结转移的独立危险因子.黏膜内癌发生淋巴结转移的2例均为直径>2 cm的印戒细胞癌;黏膜下层癌中,≤2 cm肿瘤的淋巴结转移率为16.1%(5/31),>2 cm肿瘤的淋巴结转移率高达47.8%(11/23)(P=0.012).高分化程度的早期胃癌的淋巴结转移率为0(0/13),中分化癌转移率为18.2%(4/22),低分化癌转移率为16.7%(5/30),印戒细胞癌转移率为23.7%(9/38),各组间差异无统计学意义(P=0.294).患者的年龄、性别、肿瘤部位(胃上部、中部、下部)和大体分型(隆起型、平坦型和凹陷型)与淋巴结转移无相关性.结论 肿瘤大小和浸润深度与早期胃癌淋巴结转移相关,决定早期胃癌治疗方案时,可参考上述因素判断淋巴结转移风险.     

颈部淋巴结结核患者疾病进展的危险因素分析

目的 分析颈部淋巴结结核患者规范抗结核治疗过程中疾病进展的临床特征,并进行相关影响因素分析,为该疾病治疗提供新的理念及依据。方法 回顾性分析2020年3月至2022年3月成都市公共卫生临床医疗中心确诊为颈部淋巴结结核并进行规范抗结核治疗患者的临床资料。根据疾病转归分为进展组与未进展组,对两组患者性别、年龄、免疫细胞计数及合并症等基线资料进行统计分析,并对影响疾病进展及复发的相关因素进行单因素与多因素分析。结果 本研究共纳入颈部淋巴结结核患者129例,其中进展组70例,未进展组59例。进展组与未进展组患者CD4⁺T淋巴细胞计数(P <0.001)、CD8⁺T淋巴细胞计数(P=0.005)、NK细胞计数(P <0.001)、合并纵隔淋巴结肿大(P <0.001)、初治与复治(P <0.001)、是否耐药(P=0.004)差异有统计学意义(P <0.05)。多因素Logistic回归分析发现较低的NK细胞计数(OR=39.968,95%CI 9.324～171.333,P<0.001)、复治(OR=24.118,...     

Predictive risk factors for lymph node metastasis in patients with small size non-small cell lung cancer

Background

Accurate clinical staging of non-small cell lung cancer (NSCLC) is essential for developing an optimal treatment strategy. This study aimed to determine the predictive risk factors for lymph node metastasis, including both N1 and N2 metastases, in clinical T1aN0 NSCLC patients.

Methods

We retrospectively evaluated clinical T1aN0M0 NSCLC patients who showed no radiologic evidence of lymph node metastasis, and who had undergone surgical pulmonary resection with systematic mediastinal node dissection or sampling at the First Affiliated Hospital of Zhejiang University between January 2011 and June 2013. Univariate and multivariate logistic regression analyses were performed to identify predictive factors for node metastasis.

Results

Pathologically positive lymph nodes were found in 16.2% (51/315) of the patients. Positive N1 nodes were found in 12.4% (39/315) of the patients, and positive N2 nodes were identified in 13.0% (41/315) of the patients. Some 9.2% (29/315) of the patients had both positive N1 and N2 nodes, and 3.8% (12/315) of the patients had nodal skip metastasis. Variables of preoperative radiographic tumor size, non-upper lobe located tumors, high carcinoembryonic antigen (CEA) levels and micropapillary predominant adenocarcinoma (AC) were identified as predictors for positive N1 or N2 node multivariate analysis.

Conclusions

Pathologically positive lymph nodes were common in small size NSCLC patients with clinical negative lymph nodes. Therefore, preoperative staging should be performed more thoroughly to increase accuracy, especially for patients who have the larger size, non-upper lobe located, high CEA level or micropapillary predominant ACs.     

Identification of risk factors for lymph node metastasis of colorectal cancer

BACKGROUND/AIMS: Although lymph node metastasis is widely considered to be the potent prognostic factor in colorectal cancer patients, the clinical risk factors for lymph node metastasis in these patients have been scarcely analyzed. METHODOLOGY: The clinical records of 2125 patients who underwent colonoscopy and were diagnosed with colorectal cancer were reviewed. RESULTS: Multivariate analysis revealed that an increase in T stage (odds ratio (OR); 2.54, 95% confidence interval (CI) 2.17-2.98), and tumors with high grade pathology (OR; 1.63, 95% CI 1.10-2.41) were identified as the independent predictive factors for the presence of lymph node metastasis. On the other hand, the presence of synchronous adenomas (OR; 0.78, 95% CI 0.65-0.95) was a predictor for being free of lymph node metastasis. Stratification of the risk according to age and gender revealed that a tumor located in the right colon indicated significant risk for patients less than 50 years old (OR; 2.23, 95% CI 1.01-4.95), whereas tumors with high grade pathology indicated a significant risk only in female patients (OR; 1.74, 95% CI 1.01-3.00). CONCLUSIONS: The significant risk factors for lymph node metastasis were elucidated, and may facilitate surgeons in deciding the best surgical procedure to implement and pathologists in treating resected specimens.     

分化型甲状腺癌颈部淋巴结转移的相关危险因素分析

目的分析分化型甲状腺癌(DTC)患者的超声及实验室检查结果,探讨影响DTC颈部淋巴结转移的因素。方法选取2019-01～2019-12于该院接受手术治疗且经术后病理确诊为DTC的133例患者资料,根据术后病理结果是否存在颈部淋巴结转移分为转移组(78例)和无转移组(55例)。收集两组患者的一般临床资料、实验室检查资料及超声检查资料并进行比较,采用多元Logistic回归分析影响DTC颈部淋巴结转移的因素。结果与无转移组相比,转移组的男性人数比例较大,年龄较小,有结节内钙化的人数比例及结节直径较大,差异有统计学意义(P 0.05)。转移组血清促甲状腺激素(TSH)水平、抗甲状腺球蛋白抗体(TGAb)阳性率和抗甲状腺过氧化物酶自身抗体(TPOAb)阳性率高于无转移组,差异有统计学意义(P 0.05)。多因素Logistic回归分析结果显示,发生结节内钙化、TGAb阳性和较大的结节直径是促进DTC颈部淋巴结转移发生的危险因素(P 0.05),而较高的年龄和女性是DTC颈部淋巴结转移发生的保护因素(P 0.05)。结论男性、年龄小、结节直径大、结节内钙化、TGAb阳性是DTC患者发生颈部淋巴结转移的危险因素,术前完善超声及血清学检查对指导DTC手术及预后评估有重要意义。     

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

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 me     

Risk factors of non-sentinel lymph node metastasis in 443 breast cancer patients with sentinel lymph node-positive

Axillary lymph node dissection is the standard surgical procedure for breast cancer patients with sentinel lymph node (SLN) positive. In clinical practice, axillary lymph node dissection may be an unnecessary treatment for some breast cancer patients with non-sentinel lymph node (NSLN) negative. The aim of this study was to analyze the risk factors of NSLN metastasis in breast cancer patients with SLN positive. Four hundred fifty-six clinical early stage breast cancer patients with SLN positive were collected and analyzed in the oncological surgery department of Fujian Provincial Hospital during 2013 to 2018. All these patients underwent surgical treatment. The average age and tumor size of 443 patients with SLN positive breast cancer were (49.8 ± 10.8) years and (2.42 ± 0.94) cm. Univariate analysis showed that the size of primary tumor, the number of positive SLN, the number of negative SLN, the ratio of positive SLNs, and the type of metastases in SLN were the influencing factors of NSLN metastasis. Multivariate regression analysis showed that primary tumor size T > 2 cm (P < .001, OR = 2.609), the positive number of SLNs ≥3 (P = .002, OR = 5.435), the ratio of positive SLNs ≥ 50% (P = .017, OR = 1.770), and SLN macrometastases (P < 0.001, OR = 16.099) were independent risk factors for NSLN metastasis. Combined with the 4 independent risk factors, the area under the curve to predict NSLN metastasis was 0.747 > 0.7. For clinical early breast cancer with positive SLN, primary tumor size T > 2 cm,the positive number of SLNs ≥ 3, the ratio of positive SLNs ≥ 50%, and SLN macrometastases could predict NSLN metastasis well, and guide surgery to avoid overtreatment.     

老年未分化型早期胃癌淋巴结转移的危险因素分析

目的总结老年患者未分化型早期胃癌（early gastric cancers,EGCs）的临床病理特征,分析未分化型EGCs淋巴结转移的危险因素。方法纳入2010年1月—2019年8月在北京协和医院行根治性胃癌切除+淋巴结清扫术,手术病理诊断符合EGCs的老年（≥65岁）患者,以分化型EGCs为对照,比较分析未分化型EGCs（即印戒细胞癌和低分化腺癌）的临床病理特征。用Logistic回归对老年未分化型EGCs淋巴结转移风险进行多因素分析。结果纳入老年EGCs共165例,其中未分化型EGCs 82例（印戒细胞癌11例,低分化腺癌 71例）,分化型EGCs 83例。淋巴结转移率方面,老年EGCs淋巴结转移率为9.1%（15/165）,分化型EGCs淋巴结转移率为4.8%（4/83）,未分化型EGCs淋巴结转移率为13.4%（11/82）。未分化型EGCs中,低分化腺癌淋巴结转移率为15.5%（11/71）,印戒细胞癌11例均无淋巴结转移。单因素分析提示浸润深度（P=0.019)、病变大小（P=0.006）、合并溃疡（P=0.006）、凹陷型（P=0.003）与老年未分化型EGCs淋巴结转移相关。多因素分析提示黏膜下层浸润（OR=11.98,95%CI:1.17~122.84,P=0.037 ）、病变直径＞2 cm（OR=11.95,95%CI:1.88~76.07,P=0.009)是老年未分化型EGCs淋巴结转移的独立危险因素。所有满足扩大适应证的老年未分化型EGCs无淋巴结转移。结论黏膜下层浸润、病变直径＞2 cm是老年未分化型EGCs淋巴结转移的独立危险因素。满足扩大适应证的老年未分化型EGCs患者适合内镜黏膜下剥离术治疗。     

单侧甲状腺乳头状癌伴同侧颈侧区淋巴结转移患者发生对侧中央区淋巴结转移的影响因素

目的 探讨伴同侧颈侧区淋巴结转移(LLNM)的单侧甲状腺乳头状癌(PTC)患者对侧中央区淋巴结(Cont-CLNs)转移的影响因素。方法 选取2018年7月至2022年7月江苏省原子医学研究所附属江原医院收治的LLNM-PTC患者127例,根据其是否发生Cont-CLNs转移,分成转移组(n=68)和非转移组(n=59)。收集患者的资料,包括性别、年龄、肿瘤大小、肿瘤回声、血流信号、有无微钙化、肿瘤数量、病变腺叶、结节性甲状腺囊肿、被膜侵犯、有无桥本甲状腺炎以及患侧中央区淋巴结、气管前淋巴结与喉前淋巴结转移发生率与术后并发症情况。采用二元logistic回归模型分析LLNM-PTC患者发生Cont-CLNs转移的影响因素。采用SPSS 20.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ²检验。结果 转移组男性、微钙化、多发性肿瘤、被膜侵犯占比分别为75.00%(51/68)、47.06%(32/68)、55.88%(38/68)、47.06%(32/68),高于非转移组的37.29%(22/59)、16.95%(10/59)、18.64%(11/59)、15.25%(9/59),且转移组肿瘤最大径大于非转移组(P＜0.05)。转移组患侧中央区淋巴结、气管前淋巴结、喉前淋巴结转移率分别为51.47%(35/68)、44.12%(30/68)、50.00%(34/68),高于非转移组的20.34%(12/59)、15.25%(9/59)、16.95%(10/59),差异有统计学意义(P＜0.05)。二元logistic回归分析显示,男性、肿瘤太大、微钙化、多发性肿瘤、被膜侵犯、患侧中央区淋巴结转移、气管前淋巴结转移、喉前淋巴结转移是患者发生Cont-CLNs转移的独立危险因素,差异有统计学意义(P＜0.05)。结论 LLNM-PTC患者发生Cont-CLNs转移受多种因素影响,包括性别、肿瘤大小、微钙化、肿瘤数量、被膜侵犯以及患侧中央区、气管前、喉前的淋巴结转移,日后诊疗中需引起重视。     

子宫内膜癌淋巴结转移规律探讨

目的　探讨子宫内膜癌淋巴结转移规律。方法　对接受全子宫、盆腔淋巴结切除术的160例子宫内膜癌患者,观察并记录其肿瘤所处子宫腔位置、子宫肌层浸润深度、分期、病理类型、细胞学分级及切除淋巴结位置、总数及阳性淋巴结数,并进行相关分析。结果 肿瘤位于宫底部、体部、累及宫颈者淋巴结转移率分别为19.2％、21.2％、35.9％,均以髂外淋巴结转移最常见。病灶局限于宫底、宫体部者多为髂外、闭孔淋巴结转移;累及宫颈者以髂外、髂总淋转移为常见;前者髂总淋巴结转移率为25％,后者为71.3％,P<0.01。所有腹主动脉旁淋巴结阳性及累及宫颈者的髂总淋巴结均有转移,而病灶限于宫体的腹主动脉旁淋巴结转移者仅有30％髂总淋巴结阳性。肿瘤的肌层浸润深度、病理类型及分化程度与盆腔淋巴结转移密切相关。结论 宫体部子宫内膜癌可直接或由宫颈转移至髂外淋巴结,宫颈受累者最易发生髂总和髂外淋巴结转移。宫颈受累者髂总淋巴结可作为腹主动脉旁淋巴结的前哨淋巴结。     

影响大肠癌淋巴结转移的因素间相关性探讨

目的研究影响大肠癌淋巴结转移的各种临床及病理因素之间的关系,为临床诊断及治疗提供参考.方法收集我院1975/1999年间手术治疗的大肠癌1374例,对全部病例及随访资料进行分析,建立ACCESS数据库,进行检索,采用排列组合的方法,逐个分析年龄、浸润深度、侵犯肠管周径、病理类型、分化程度、生长方式、肿瘤部位之间的相关性.统计方法采用行×列表资料的χ2检验.结果小于30岁年龄组大肠癌浸润肠管周径较其他年龄组高,其粘液腺癌、印戒细胞癌所占比例分别为22.7%(17/75),14.7%(11/75),较其他年龄组均多(P=0.000 χ2=72.22);与肿瘤浸润肠管周径有关的因素有肿瘤浸润肠壁深度(P=0.000 χ2=353.58),肿瘤生长方式(P=0.000χ2=155.35),肿瘤分化程度(P=0.035 χ2=13.53)肿瘤病理类型(P=0.000 χ2=31.64),肿瘤部位(P=0.000χ2=44.73);粘液腺癌及印戒细胞癌浸润至浆膜层的比例为81.6%(120/147)和86.36%(19/22)显著高于腺癌组67.7%(574/848);分化程度低的肿瘤及浸润性生长的肿瘤其浸润肠壁的深度增高;直肠癌及乙状结肠癌浸润到肠壁外的比例分别为要较其他组低(P=0.000 χ2=36.96).升结肠,横结肠,降结肠癌中粘液腺癌所占比例均较乙状结肠及直肠高(P=0.000χ2=83.55),其中横结肠癌中粘液腺癌所占比例高达38.5%(40/104).高分化,中分化,低分化癌中浸润性生长者分别为55.8%(191/342),62.5%(226/361),68.9%(59/86)组间比较有显著性差别(P=0.002 χ2=21.48).结论影响大肠癌淋巴结转移的各因素之间是相互联系、相互影响的.不可能以单一的某种因素作为判断其有无淋巴结转移的指标,临床上需综合分析各种因素所起的作用才能对病情进行合理正确的评估,制定合理的治疗方案.     

Sentinel lymph node concept in gastric cancer with solitary lymph node metastasis

AIM: To study the localization of the solitary metastases in relation to the primary gastric cancers and the feasibility of sentinel lymph node (SLN) concept in gastric cancer. METHODS: Eighty-six patients with gastric cancer, who had only one lymph node involved, were regarded retrospectively as patients with a possible sentinel node metastasis, and the distribution of these nodes were assessed. Thirteen cases with jumping metastases were further studied and followed up. RESULTS: The single nodal metastasis was found in the nearest perigastric nodal area in 65.1% (56/86) of the cases and in 19.8% (17/86) of the cases in a fairly remote perigastric area. Out of 19 middle-third gastric cancers,3 tumors at the lesser or greater curvatures had transverse metastases. There were also 15.1% (13/86) of patients with a jumping metastasis to N2-N3 nodes without N1 involved. Among them, the depth of invasion was mucosal (M) in 1 patient, submucosal (SM) in 2, proper-muscular (MP) in 4, subserosal (SS) in 5, and serosa-exposed (SE) in 1. Five of these patients died of gastric cancer recurrence at the time of this report within 3 years aftersurgery. CONCLUSION: These results suggest that nodal metastases occur in a random and multidirectional process in gastric cancer and that not every first metastatic node is located in the perigastric region near the primary tumor. The rate of “jumping metastasis” in gastric cancer is much higher than expected, which suggests that the blind examination of the nodal area close to the primary tumor can not be a reliable method to detect the SLN and that a extended lymph node dissection (ELND) should be performed if the preoperative examination indicates submucosal invasion.