黏膜内早期胃癌淋巴结转移相关因素分析

Analysis of associated factors of lymph node metastasis in intramucosal early gastric cancer

目的探讨黏膜内早期胃癌淋巴结转移的相关临床病理因素，为早期胃癌的个体化治疗提供依据。方法回顾性分析2006年6月至2011年10月间在复旦大学附属中山医院接受根治性切除术并经病理证实的498例黏膜内早期胃癌患者的临床资料．采用单因素和多因素Logistic回归分析来评估影响黏膜内早期胃癌淋巴结转移的危险因素。结果498例患者中有43例（8．6％）发生淋巴结转移。病灶大小（HR=1．525，95％CI：1．040-2．236）、肿瘤侵犯深度（HR=1．656，95％CI：1．158。2．368）和组织学类型（HR=8．149，95％CI：1．770～37．513）是影响黏膜内早期胃癌淋巴结转移的独立危险因素。结论根据临床病理因素可对黏膜内早期胃癌的淋巴结转移进行预测并指导治疗方案的制订。

Objective To analyze the associated predictive factors of lymph node metastasis in intramucosal early gastric cancer, and to provide reference for individualized treatment protocol. Methods Clinical data of 498 patients who were pathologically confirmed to be intramucosal early gastric cancer after radical resection of gastric cancer were retrospectively reviewed. Univariate and multivariate analyses were applied to evaluate the associated factors. Results Forty-three out of 498 patients （8.6%） had lymph node metastasis. Tumor size （HR=1.525, 95%CI：1.040-2.236）, depth of invasion （HR=1.656, 95%CI： 1.158-2.368） and histological type （HR=8.149, 95%CI： 1.770-37.513） were the independent risk factors for lymph node metastasis in intramucosal early gastric cancer. Conclusions Prediction and therapeutic guidance for lymph node metastasis in intramucosal early gastric cancer can be carried out according to clinicopathological risk factors.