早期胃癌临床病理特征与淋巴结转移的关系及其对预后的影响

Relationship between clinicopathological features and lymph node metastasis in early gastric cancer and its influence on prognosis

目的:分析胃癌早期患者临床病理特征和淋巴结转移之间的关系及其对预后的影响。方法:对2013年1月-2014年9月广东省深圳市龙华区人民医院术后病理确诊为早期胃癌(EGC)的198例患者的临床资料开展回顾性分析,依据淋巴结转移性质分成阴性组(n=164)与阳性组(n=34),对比两组在临床病理特征方面的差异,探讨EGC患者临床病理特征与淋巴结转移之间的关系,同时依据患者的5年生存情况分成死亡组(n=56)和生存组(n=142),分析EGC患者预后的影响因素。结果:淋巴结转移阴性组与阳性组在性别、大体分型、浸润深度、分化程度、肿瘤大小等方面差异均有统计学意义(P<0.05),采用Logistic回归方程进行多因素分析后发现,肿瘤大小、分化程度、浸润深度及性别的OR值均>1,均是淋巴结转移的影响因素(P<0.05);死亡组与生存组在年龄、有无溃疡和淋巴结转移方面差异均有统计学意义(P<0.05),采用Logistic回归方程进行多因素分析后发现,上述因素OR值均>1,均是预后的影响因素(P<0.05)。结论:肿瘤大小、分化程度、浸润深度及性别对预测及评定EGC患者淋巴结转移有着重要作用,而年龄、有无溃疡和淋巴结转移均会对患者预后产生影响。

Objective: To analyze the relationship between clinicopathological features and lymph node metastasis in early gastric cancer and its influence on prognosis. Methods: The clinical data of 198 patients with early gastric cancer(EGC) confirmed by pathology in our hospital from January 2013 to September 2014 were retrospectively analyzed. According to the nature of lymph node metastasis, the patients were divided into negative group(n=164) and positive group(n=34). The differences between the two groups in clinical and pathological characteristics were compared to explore the relationship between various clinical and pathological characteristics of EGC patients and lymph node metastasis. The 5-years survival of patients with EGC was divided into death group(n=56) and survival group(n=142), analyzed the prognostic factors of EGC patients. Results: There were significant differences in sex, general classification, invasion depth, differentiation degree and tumor size between the negative group and the positive group of lymph node metastasis(P<0.05).Logistic regression analysis showed that the or values of tumor size, differentiation degree, invasion depth and gender were all >1, which were the influencing factors of lymph node metastasis(P<0.05);There were statistically significant differences in age, ulcer and lymph node metastasis between the death group and the survival group(P<0.05). After multivariate analysis by logistic regression equation,it was found that the or values of the above factors were all >1, which were the influencing factors of prognosis(P<0.05). Conclusion: Tumor size, degree of differentiation,depth of invasion and gender play an important role in the prediction and evaluation of lymph node metastasis in EGC patients, while age, presence or absence of ulcer and lymph node metastasis will affect the prognosis of patients.