中国实用外科杂志

中国实用外科杂志

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早期胃癌淋巴结转移相关危险因素研究

尹    杰，蔡    军，张    军，郑    智，刘    钊，张忠涛   

  1. 首都医科大学附属北京友谊医院普外科 国家消化系统疾病临床医学研究中心，北京 100050
  • 出版日期:2016-01-01 发布日期:2015-12-31

  • Online:2016-01-01 Published:2015-12-31

摘要：

目的    探讨早期胃癌淋巴结转移危险因素。方法    回顾性分析首都医科大学附属北京友谊医院自2008年1月至2015年1月手术治疗（开放手术或腹腔镜手术）112例早期胃癌病人临床病理学资料，采用Logistic回归模型进行研究。结果 多因素分析示，年龄、浸润深度、组织学类型、脉管内瘤栓与淋巴结转移存在相关性。分层分析示，年龄＜60岁、侵犯黏膜下层、分化不良且合并脉管内瘤栓者更易出现淋巴结转移。结论    年龄、浸润深度、组织学类型及脉管内瘤栓是淋巴结转移的危险因素；年龄≥60岁、肿瘤局限于黏膜内、分化型且无脉管内瘤栓者可行单纯内镜下切除，具有以上高危因素者，建议根据具体情况加行淋巴结清扫术。

关键词: 早期胃癌, 淋巴结转移

Abstract:

Study on related risk factors and prognosis for lymph node metastasis in patients with early gastric cancer                  YIN Jie, CAI Jun, ZHANG Jun, et al.Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050,China
Corresponding author: Zhang Zhong-tao, E-mail：zhangzht@medmail.com.cn
Abstract    Objective    The purpose of study was to analyze the risk factors for lymph node metastasis (LNM) in patients with early gastric cancer (EGC). Methods    This study retrospectively reviewed 112 patients who underwent surgery. The clinical characteristics and pathological features were analyzed by using chi-square and binary logistic regression. Results    Logistic regression analysis revealed that age, depth of infiltration, neoplasms histologic type and lymphatic embolus were independent risk factors for LNM. Further study has showed that no LNM was observed for patients with mucous cancer, who were over 60 years old and with a highly differentiated tumor without lymphatic embolus. However, LNM would occured if the neoplasms infiltrated within the submucous layer. Conclusion    LNM of EGC is related with age, depth of infiltration, histological type of tumor and lymphatic embolus. Therefore, we believed that endoscopic En-bloc dissection might be considered as the surgical treatment for patients with over 60 years old and highly differentiated tumor which invaded mucous layer without lymphatic embolus. With respect to the patients with high risk factors, we recommend that appropriate lymphadenectomy was conducted according to the specific situation.

Key words: early gastric cancer, lymphatic metastasis