中老年早期胃癌浸润深度相关因素分析及其与淋巴结转移的关系

目的 研究中老年早期胃癌浸润深度与临床病理特征的相关性,探讨早期胃癌浸润深度的相关危险因素及其与淋巴结转移的关系.方法 回顾分析2013年1月-2019年12月,六安市人民医院普通外科收治的110例中老年早期胃癌患者的临床及病理资料,分析早期胃癌浸润深度和淋巴结转移与各临床病理特征的关系,采用logistic回归模型分...

Analysis of the related factors of the invasion depth of gastric cancer in middle-aged and elderly patients

  Objective  To analyze the correlation between the depth of infiltration of early gastric cancer (EGC) and clinicopathological features in middle-aged and elderly patients, and to explore the risk factors for the depth of infiltration of EGC and its relationship with lymph node metastasis (LNM).  Methods  The clinicopathological data of 110 patients with EGC admitted to the General Surgery Department of Lu'An Affiliated Hospital of Anhui Medical University from January 2013 to December 2019 were retrospectively collected. The relationship between the infiltration depth, LNM and clinicopathological features were analyzed. A logistic regression model was used to analyze the independent risk factors for the infiltration depth and LNM.  Results  Of the 110 patients, 54 had tumors confined to the mucosal layer, of which 53 patients had no LNMs and 1 had LNMs, and 56 had tumors invading the submucosal layer, of which 44 patients had no LNMs and 12 patients had LNMs. Univariate analysis showed no statistically significant differences between the two groups with different depth of infiltration in terms of gender (P=0.739), age (P=0.336), gross type classification (P=0.815), tumor location (P=0.410), differentiation (P=0.519), vascular invasion (P=0.057) and perineural invasion (P=0.243). Patients with tumor size ≥2 cm (P=0.005) and LNM (P=0.001) had a higher proportion of tumors invading the submucosa than those confined to the mucosal layer. Multivariate logistic regression analysis showed that tumor size (P=0.016) was an independent influence on the depth of infiltration of EGC, and further analysis revealed that the depth of infiltration (P=0.044) was an independent influence on LNM of EGC.  Conclusion  Tumor size was the independent risk factor of the tumor invasive depth. EGC with a tumor size of ≥2 cm may be more likely to have tumor invasion of the submucosal layer and a greater risk of LNM. It is recommended that the middle-aged and elderly patients with EGC whose tumor diameter is ≥2 cm and invades the submucosal layer should be careful when choosing endoscopic submucosal dissection or radical gastrectomy with inadequate lymph node dissection.