摘要
目的探讨早期胃癌淋巴结转移危险因素。方法回顾性分析首都医科大学附属北京友谊医院自2008年1月至2015年1月手术治疗(开放手术或腹腔镜手术)112例早期胃癌病人临床病理学资料,采用Logistic回归模型进行研究。结果多因素分析示,年龄、浸润深度、组织学类型、脉管内瘤栓与淋巴结转移存在相关性。分层分析示,年龄<60岁、侵犯黏膜下层、分化不良且合并脉管内瘤栓者更易出现淋巴结转移。结论年龄、浸润深度、组织学类型及脉管内瘤栓是淋巴结转移的危险因素;年龄≥60岁、肿瘤局限于黏膜内、分化型且无脉管内瘤栓者可行单纯内镜下切除,具有以上高危因素者,建议根据具体情况加行淋巴结清扫术。
Objective The purpose of study was to analyze the risk faetors for lymph node metastasis （LNM） in patients with early gastric cancer （EGC）. Methods This study retrospectively reviewed 112 patients who underwent surgery. The clinical characteristics and pathological features were analyzed by using chi-square and binary logistic regression. Results Logistic regression analysis revealed that age, depth of infiltration, neoplasms histologic type and lymphatic embolus were independent risk factors for LNM. Further study has showed that no LNM was observed for patients with mucous cancer, who were over 60 years old and with a highly differentiated tumor without lymphatic embolus. However, LNM would occured if the neoplasms infiltrated within the submucous layer. Conclusion LNM of EGC is related with age, depth of infiltration, histological type of tumor and lymphatic embolus. Therefore, we believed that endoscopic En-bloc dissection might be considered as the surgical treatment for patients with over 60 years old and highly differentiated tumor which invaded mucous layer without lymphatic embolus. With respect to the patients with high risk factors, we recommend that appropriate lymphadenectomy was conducted according to the specific situation.
出处
《中国实用外科杂志》
CSCD
北大核心
2016年第1期111-114,118,共5页
Chinese Journal of Practical Surgery
基金
国家自然科学基金(No.81172317
81541050)
北京市自然科学基金(No.7154191)
北京市优秀人才培养资助(No.2014000021469G266)
北京友谊医院科研启动基金资助项目
关键词
早期胃癌
淋巴结转移
early gastric cancer
lymphatic metastasis
