影响早期胃癌患者淋巴结转移的相关临床病理因素分析

Clinical Investigation of Associations between Early Lymphatic Metastasis of Gastric Cancer and Pathological Features

目的探讨早期胃癌发生转移的规律,为选择合适的治疗方案提供思路。方法收集2006年1月-2012年12月间安康市中心医院收治并确诊的早期胃癌患者118例,对8个可能与早期胃癌淋巴结转移发生有关的因素进行单因素和多因素logistic回归分析。结果有无溃疡、肿瘤大小、浸润深度及有无淋巴管浸润4个因素淋巴结转移率分别比较具有统计学意义(P<0.05);进一步多因素logistic回归分析显示,影响淋巴结转移的独立危险因素包括有溃疡、肿瘤大小≥3 cm、浸润深度至黏膜下层、有淋巴管浸润(OR值分别为2.872、2.351、3.461、1.784,均P<0.05)。结论早期胃癌发生淋巴结转移与多因素有关,建议术前严格筛查,排除各危险因素并选择合理的治疗方案。

Objective To investigate the rule of lymph node metastasis in early gastric cancer （EGC） so as to provide a reasonable treatment. Methods We retrospectively analyzed the clinical data of 118 EGC patients who had been treated from January 2006 to December 2012, and a total of 8 potential factors associated with occurrence of EGC were evaluated by univariate analysis and multivariate logistic regression analysis. Results The univariate analysis showed that ulcer, tumor size, depth of invasion and lymphatic involvement were correlated with lymph node metastasis （P 〈 0.05）. Multivariate logistic regression analysis showed that presence of an ulcer （OR=2.872）, tumor of 3.0 cm or larger than that （OR=2.351）, tumor invasion into the submucous layer （OR=3.461 ） and invasion into the lymphatic tubes （OR=1.784） were found to be independent risk factors. Conclusion Lymph node metastasis of EGC is correlated with many factors, so EGC treatment choice should be made reasonably based on strict screening to exclude various risk factors before taking surgery.