胃癌No.14v组淋巴结转移的危险因素及预后分析

目的 探讨胃癌No.14v组淋巴结转移的危险因素及对预后的影响。方法 回顾性分析72例行胃癌D2根治术+No.14v组淋巴结清扫患者的临床资料。采用Logistic回归分析影响No.14v组淋巴结转移的因素，Cox回归分析No.14v组淋巴结转移与预后的关系。结果 No.14v组淋巴结转移率为25.0%（18/72）。Logistic回归分析显示，Borromann分型Ⅲ~Ⅳ型（OR=81.508，95%CI：4.805~1　382.635，P=0.002）、远处转移（OR=11.494，95%CI：1.085~121.723，P=0.043）和TNM分期Ⅲ~Ⅳ期（OR=8.101，95%CI：1.355~48.437，P=0.005）是影响No.14v组淋巴结转移的独立危险因素。No.14v组淋巴结转移组患者的中位生存时间低于非转移组（22个月 vs 33 个月，χ²=22.737，P<0.001）；多因素Cox回归分析显示，No.14v组淋巴结转移是影响患者总生存期的独立影响因素（HR=2.881，95%CI：1.222~6.793，P=0.016）。 结论 No.14v组淋巴结转移的胃癌患者预后较差，Borromann分型Ⅲ~Ⅳ型、远处转移及TNM分期Ⅲ~Ⅳ期是No.14v组淋巴结转移的独立危险因素。

Risk factors and prognostic analysis of lymph node metastasis in No.14v group in gastric cancer

Objective To investigate the risk factors and to perform prognostic analysis of lymph node metastasis in the No.14 v group in gastric cancer. Methods The clinical data of 72 gastric cancer patients who underwent radical gastrectomy with lymph node in the No.14 v group dissection were analyzed retrospectively. Logistic regression was used to analyze the factors affecting lymph node metastasis in the No.14 v group,Cox regression was used to analyze the relationship between lymph node metastasis in the No.14 v group and prognosis. Results The lymph node metastasis rate in the No.14 v group was 25.0%(18/72). Logistic regression analysis showed that Borromann classification Ⅲ-Ⅳ(OR=81.508,95%CI:4.805-1 382.635,P=0.002),distant metastasis(OR=11.494,95%CI:1.085-121.723,P=0.043),and TNM stages Ⅲ-Ⅳ(OR = 8.101,95%CI :1.355-48.437,P= 0.005) were independent risk factors affecting lymph node metastasis in the No.14 v group. The median overall survival of patients with lymph node metastasis in the No.14 v group was lower than that in the non-metastatic group(22 months vs 33 months,χ~2= 22.737,P<0.001). Multivariate Cox regression analysis showed that lymph node metastasis in the No.14 v group was an independent influencing factor for the overall survival of patients(HR=2.881,95%CI:1.222-6.793,P=0.016). Conclusions Patients with lymph node metastasis in the No.14 v group have a poor prognosis in gastric cancer,and the independent risk factors for lymph node metastasis in the No.14 v group include Borromann classificationⅢ-Ⅳ,distant metastasis,and TNM stage Ⅲ-Ⅳ.