影响早期胃癌淋巴结转移相关因素分析

Risk factors of lymph node metastasis in early gastric cancer

目的探讨影响早期胃癌病人淋巴结转移的相关因素。方法回顾性分析海军军医大学附属长海医院普外科2015年1月至2018年11月220例早期胃癌病人临床资料,包括性别、年龄、体重指数(BMI)、个人史、家族史、病变部位、病理特征。结果病人淋巴结转移率,男性与女性病人比较(10%vs.22%,χ2=5.469,P=0.019),肿瘤最大径<2 cm与≥2 cm病人比较(7%vs.21%,χ2=8.375,P=0.004),肿瘤浸润黏膜层与浸润黏膜下层者比较(5%vs.28%,χ2=21.455,P<0.001),合并溃疡与无溃疡病人比较(20%vs.10%,χ2=4.151,P=0.042),病理学分型为分化型、混合型和未分化型3组病人比较(分别为11%、27%和12%,χ2=6.143,P=0.046),差异均有统计学意义。多因素分析显示,肿瘤浸润深度可能是早期胃癌淋巴结转移的相关因素(OR=0.115,P<0.05)。结论女性、肿瘤最大径≥2 cm、肿瘤浸润至黏膜下层及病理学分型为混合型是早期胃癌发生淋巴结转移的可能相关影响因素,仍有待进一步扩大样本分析验证。

ObjectiveTo evaluate the risk factors of early gastric cancer with lymph node metastasis.MethodsClinicopathological data of 220 early gastric cancer cases admitted at Changhai Hospital of Navy Military Medical University from January 2015 to November 2018 were analyzed retrospectively.The statistical analysis was conducted to evaluate gender,age,BMI,personal history,family history,tumor location,pathological features.ResultsThe difference of lymph node metastasis between male and female(10%vs.22%,χ^2=5.469,P=0.019),patients with tumor diameter<2 cm and≥2 cm(7%vs.21%,χ^2=8.375,P=0.004),patients with mucous invasionand submucous invasion(5%vs.28%,χ^2=21.455,P<0.001),patients with ulceredand without ulcer(20%vs.10%,χ^2=4.151,P=0.042),among patients with differentiated histology(11%,27%,12%respectivly,χ^2=6.143,P=0.046)were statistically significant.Univariate analysis showed a positive relationship between depth of tumor invasion(OR=0.115,P<0.05)and lymph node metastasis in early gastric cancer.ConclusionFemale,tumor diameter≥2 cm,in submucous invasion and mixed histology may be risk factors for lymph node metastasis in early gastric cancer,which need further analysis.