早期胃癌淋巴转移临床病理因素探讨

Histopathological risk factors for lymph node metastasis in early gastric cancer

目的探讨早期胃癌淋巴转移临床病理相关因素,预测淋巴转移风险。方法收集浙江大学医学院附属第二医院2006-2009年214例早期胃癌标本,利用二元Logistic回归模型分析患者年龄、性别、形态、病灶大小、浸润深度、病理组织学、及脉管侵犯等因素与早期胃癌淋巴转移相关性。结果 Logistic回归分析提示病灶大小[OR=2.014,95%置信区间CI（1.049~3.865）,P=0.035]、浸润深度[OR=7.112,95%CI（2.484~20.362）,P〈0.001]、病理组织学[OR=3.353,95%CI（1.294~8.690）,P=0.013]、脉管侵犯[OR=2.812,95%CI（1.043~7.583）,P=0.041]与淋巴转移相关。结论肿瘤病灶大小、浸润深度、病理组织学及脉管侵犯是早期胃癌淋巴转移的独立风险预测因子。

Objective To explore the histopathological predictors for lymph node metastasis in early gastric cancer（EGC）.Methods From 2006 to 2009,a total of 214 patients with EGC were diagnosed and treated in The Second Affiliated Hospital,College of Medicine,Zhejiang University.The relationship between lymph node metastasis and histopathological variables such as age,gender,endoscopic appearance,tumor size,depth of invasion,pathological type and lymphatic-vascular capillary invasion was studied using the binary Logistic regression model.Results There was significant correlation between lymph node metastasis and the size of tumor [OR=2.014,95%CI（1.049-3.865）,P=0.035],depth of invasion [OR=7.112,95%CI（2.484-20.362）,P0.001],pathological type [OR=3.353,95%CI（1.294-8.690）,P=0.013],lymphatic-vascular capillary invasion [OR=2.812,95%CI（1.043-7.583）,P=0.041].Conclusion Tumor size,depth of invasion,pathological type and lymphatic-vascular capillary invasion are independent predictors for lymph node metastasis in EGC.