进展期胃癌淋巴结转移规律的Logistic回归分析

METASTATIC RULE OF LYMPH NONE IN ADVANCED GASTRIC CARCINOMA: A REGRESSIVE LOGISTIC ANALYSIS

目的探讨进展期胃癌淋巴结的转移规律。方法2004年7月-2007年7月，我院手术治疗进展期胃癌病人706例，对其临床资料进行单因素和多因素Logistic回归分析。结果进展期胃癌的淋巴结转移率为64．16％（453／706），第一站（N1）、第二站（N2）和第三站（N3）的转移率分别为61．90％（437／706）、35．86％（253／706）和7．93％（56／706）。14例病人发生“跳跃性转移”，其中N2为13例，N3为1例。单因素Logistic分析显示，肿瘤浸润深度、肿瘤长径、分化程度和Borrmann分型与胃癌淋巴结转移有关。多因素Logistic回归分析显示，浸润深度（OR=2.594，P〈0.001）、分化程度（OR=1．743，P〈0．01）和肿瘤长径（OR=1．204，P〈0．001）为胃癌淋巴结转移的独立危险因素。结论进展期胃癌淋巴结转移与浸润深度、分化程度和肿瘤长径有关。

Objective To explore the rule of lymph node metastasis in advanced gastric carcinoma. Methods The clinical data of 706 patients with advanced gastric carcinoma who underwent radical gastrectomy, July 2004-July 2007 in this hospital, were analyzed by univariate and binary Logistic regression. Results The rate of lymph node metastasis was 64.16%（453/706）, of which, level I （N1）, Ⅱ（N2） and Ⅲ（N3） lymph node metastasis was 61.90%（437/706）, 35.86%（253/706） and 7.93%（56/ 706）, respectively. Skipping metastasis was found in 14 cases, including 13 cases in N1 and one in N2. Univariate logistic analysis revealed that the depth of invasion, tumor size, histological type and Borrmann typing were correlated with lymph node metastasis. Binary logistic analysis found that the depth of invasion （OR= 2.594,P〈0.001）, differentiation （OR= 1.743, P〈0.01） and the tumor size （OR = 1.204, P〈0.001） were the independent risk factors responsible for lymph node metastasis. Conclusion Lymph node metastasis in advanced gastric carcinoma is correlated with the depth of invasion, histological type and tumor size.