摘要
目的探讨影响老年早期胃癌患者淋巴结转移的危险因素,为临床选择合理的治疗方案提供理论依据。方法回顾性收集2009年1月1日-2020年10月31日,某院普外科205例行根治性手术治疗的老年早期胃癌患者的临床及病理资料,观察指标包括性别、年龄、胃癌家族史、肿瘤长径、肿瘤部位、大体类型、浸润深度、分化程度、脉管浸润、术前癌胚抗原及术前糖类抗原199。通过单因素分析及多因素Logistic回归分析,明确各指标与早期胃癌淋巴结转移之间的关系。结果205例行根治性手术治疗的老年早期胃癌患者,有26例(12.68%)出现淋巴结转移,179例(87.32%)未出现淋巴结转移。单因素分析显示,肿瘤长径(>20mm)、浸润深度(粘膜下层)、分化程度(分化不良)和脉管浸润是老年早期胃癌患者淋巴结转移的影响因素(P<0.05)。多因素Logistic回归分析显示,肿瘤浸润粘膜下层(OR:16.070,95%CI:1.232~209.658,P=0.034)及脉管浸润(OR:3.334,95%CI:1.228~9.047,P=0.018)是老年早期胃癌患者淋巴结转移的独立危险因素。结论肿瘤浸润粘膜下层及脉管浸润是老年早期胃癌患者淋巴结转移的独立危险因素。对于存在淋巴结转移高危风险的老年早期胃癌患者,应尽可能行根治性手术治疗。
Objectives To investigate the risk factors of lymph node metastasis in elderly patients with early gastric cancer and provide a theoretical basis for clinical selection of reasonable treatment. Methods The clinical and pathological data of 205 cases of elderly patients with early gastric cancer who underwent radical gastrectomy in general surgery department of our center from January 1 st, 2009 to October 31 st, 2020 were retrospectively analyzed. The observation index included gender, age, family history of stomach neoplasm, tumor length, tumor site, common type,depth of invasion, degree of differentiation, vascular invasion, preoperative CEA and preoperative CA199. Univariate analysis and multivariate logistic regression analysis were used to determine the relationship between each index and lymph node metastasis. Results Of the 205 elderly patients with early gastric cancer, 26 cases had Lymph node metastasis(12.68%), and 179 cases had no lymph node metastasis(87.32%). Univariate analysis showed that tumor length >20 mm, tumor infiltration submucosa, poor differentiation and vascular invasion were the influencing factors of lymph node metastasis in elderly patients with early gastric cancer(P<0.05). Multivariate logistic regression analysis showed that tumor infiltration submucosa(OR: 16.070, 95%CI: 1.232~209.658, P =0.034) and vascular invasion(OR: 3.334, 95%CI: 1.228~9.047, P =0.018) were independent risk factors of lymph node metastasis in elderly patients with early gastric cancer. Conclusions Tumor infiltration submucosa and vascular invasion were independent risk factors for lymph node metastasis in elderly patients with early gastric cancer. For elderly patients with early gastric cancer at high risk of lymph node metastasis, radical surgery should be performed as far as possible.
作者
隋峰
李敏哲
沈荐
Sui Feng;Li Minzhe;Shen Jian(Department of Maternal Intensive Care Unit,Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University,Beijing 100026,China)
出处
《中国病案》
2022年第1期107-110,共4页
Chinese Medical Record
关键词
老年人
早期胃癌
淋巴结转移
多因素分析
Aged
Early gastric cancer
Lymphatic metastasis
Multivariate analysis
