混合型早期胃癌淋巴结转移情况及影响因素

Lymph Node Metastasis and Influencing Factors in Mixed Early Gastric Cancer

【目的】探讨混合型早期胃癌淋巴结转移情况及影响因素。【方法】选取2018年1月到2020年1月第四军医大学第一附属医院收治的94例混合型早期胃癌患者作为研究对象。收集并整理患者的基础资料(性别、年龄、TNM分级、基础疾病、肿瘤位置、肿瘤大小、肿瘤数目、肿瘤分化程度、合并溃疡、浸润深度等),根据影像学资料结合病理结果评估患者是否存在淋巴结转移情况,并依据患者是否存在淋巴结转移将其分为转移组和未转移组。采用Logistic回归分析探讨影响混合型早期胃癌淋巴结转移的相关因素。【结果】本研究94例混合型早期胃癌患者中,22例患者出现淋巴结转移(转移组),占比23.40%;72例患者未出现淋巴结转移(未转移组),占比76.60%。转移组肿瘤大小≥2 cm、肿瘤低分化程度、合并溃疡及浸润深度至黏膜下层患者所占比例均高于未转移组,且差异有显著性(P<0.05);多因素分析结果显示,肿瘤大小≥2cm、肿瘤低分化程度、合并溃疡及浸润深度至黏膜下层均为混合型早期胃癌患者淋巴结转移的危险因素(P<0.05)。【结论】肿瘤大小≥2 cm、肿瘤低分化程度、合并溃疡及浸润深度至黏膜下层的混合型早期胃癌患者发生淋巴结转移的风险较高。

【Objective】To explore the lymph node metastasis status and its influencing factors in mixed early gastric cancer・【Methods】A total of 94 patients with mixed early gastric cancer admitted to the First Affiliated Hospital of the Fourth Military Medical University from January 2018 to January 2020 were selected to sort the basic data of patients(gender,age,TNM grade,underlying disease,tumor location,tumor size,tumor number,tumor differentiation,combined ulcers,depth of invasion,etc.).Based on imaging data in combination with pathological results,the patients-were evaluated for lymph node metastasis.Thus-patients were divided into the metastatic group and non-metastatic group according to whether there was lymph node metastasis.Logistic regression analysis was used to explore the related factors affecting lymph node metastasis in mixed early gastric cancer.【Results】Among the 94 patients with mixed early gastric cancer in this study,22 patients had lymph node metastasis(the metastasis group),accounting for 23.40%.While 72 patients did not have lymph node metastasis(the non-metastasis group),accounting for 76.60%.The proportion of patients with tumor size≥2 cm,poorly differentiated tumors,combined ulcers and depth of invasion to the submucosa in the metastasis group was higher than that in the non-metastasis group;and the difference was.statistically significant(P<0.05).The results of multivariate analysis showed that the tumor size≥2 cm,poorly differentiated tumor,combined ul-cer and depth of invasion to the submucosa in the metastasis group were risk factors for lymph node metastasis in patients、with mixed early gastric cancer(P<0.05).【Conclusion】In the metastasis group,patients with mixed early gastric cancer with tumor size≥2 cm,poorly differentiated tumors,combined with ulcers and deep infiltration to the submucosa have a higher risk of lymph node metastasis.