未分化型早期胃癌淋巴结转移的危险因素与内镜下治疗的探讨

Risk factors of lymph node metastasis and endoscopic therapy in undifferentiated early gastric cancer

目的:探讨未分化型早期胃癌淋巴结转移的危险因素,从而对未分化型早期胃癌患者,行内镜下治疗提供理论依据。方法:回顾性分析75例未分化型早期胃癌的临床病理资料,按照临床病理特征与淋巴结转移的关系进行统计学分析。结果:通过多因素分析,肿瘤大小,淋巴管癌栓和癌浸润深度对淋巴结转移具体有显著的统计学差异(P<0.05),是淋巴结转移独立的危险因素。结论:肿瘤大小>2 cm,淋巴管癌栓阳性和癌侵及黏膜下癌是未分化型早期胃癌淋巴结转移的独立危险因素。对于无危险因素的未分化早期胃癌患者,行内镜下治疗是可行且安全的。

Objective：This study aimed to investigate the clinicopathological factors predictive of lymph node metastasis（LNM） in undifferentiated early gastric cancer（EGC）, and to expand the possibility of endoscopic mucosal resection for treating undifferentiated EGC. Methods： Data of 75 patients with undifferentiated EGC and surgically treated in our hospital were collected. The association between the LNM and clinicopathological factors was retrospectively analyzed using univariate and multivariate logistic regression analyses. Results： Univariate analysis showed that the tumor size, lymphatic vessel involvement（LVI）, and depth of invasion were the significant and independent risk factors for LNM. Conclusion： The tumor size, LVI, and depth of invasion were independently associated with the presence of LNM in undifferentiated EGC. Endoscopic mucosal resection can be sufficient to treat patients without the risk factors.