中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (01): 91-93.

• 论著 • 上一篇    下一篇

胃黏膜下层癌淋巴结转移临床病理因素分析

沈历宗，黄一鸣，孙茂才，徐 皓，魏 尉，吴文溪   

  1. 南京医科大学第一附属医院普通外科，江苏南京 210029
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-03-02 发布日期:2009-03-02

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-03-02 Published:2009-03-02

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摘要：

【摘要】 目的 研究胃黏膜下层癌淋巴结转移率及其影响因素。 方法 回顾性分析南京医科大学第一附属医院1998年1月至2007年12月手术证实的181例胃黏膜下层癌的临床病理资料，对病人年龄、性别、肿瘤组织学类型、形态学类型、大小、部位、浸润深度、脉管内癌栓等与淋巴结转移的关系进行单因素与多因素分析。 结果 胃黏膜下层癌淋巴结转移率为20.44%。影响胃黏膜下层癌淋巴结转移的因素主要有肿瘤组织学类型（分化型 vs 分化不良型，P =0.0352）、直径大小（＜2cm vs ≥2cm，P =0.0143）、部位（近端胃vs胃体vs远端胃，P =0.0254）及脉管内癌栓（无vs有，P =0.0323）。Logistic回归分析显示肿瘤组织学类型与大小为胃黏膜下层癌淋巴结转移的独立性危险因素。结论 胃黏膜下层癌淋巴结转移与肿瘤组织学类型、大小、部位及脉管内癌栓等因素有关。临床上应参考上述临床病理因素判断淋巴结转移风险，制定合适的治疗方案。

关键词: 胃黏膜下层癌, 淋巴结转移

Abstract:

Clinicopathological Characteristics Associated with Lymph Node Metastasis in Early Gastric Cancer with Submucosal Invasion SHEN Li-zong, HUANG Yi-ming, SUN Mao-cai, et al. Department of General Surgery, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China Corresponind author: SHEN Li-zong, E-mail: shenlz@163.com Abstract Objective To investigate the clinicopathological characteristics of early gastric cancer with submucoal invasion associated with lymph node metastasis. Methods The data from 181 patients surgically treated for early gastric cancer with submucosal invasion between 1998 and 2007 were reviewed retrospectively. The clinicopathological variables associated with lymph node metastasis were evaluated. Results Lymph node metastasis was observed in 20.44% of patients. The histological classification, tumor size, location in the stomach and presence of vascular or lymphatic invasion showed a positive correlation with the rate of lymph node metastasis by univariate analysis. Multivariate analyses revealed histological classification and tumor size to be significantly and independently related to lymph node metastasis. Conclusion Histological classification, tumor size, location in the stomach and presence of vascular or lymphatic invasion are risk factors for lymph node metastasis in early gastric cancer with submucoal invasion. Minimal invasive treatment, such as endoscopic submucosal dissection, may be possible in highly selective cancers.

Key words: lymph node metastasis, early gastric cancer with submucosal invasion