Liu Caigang, Zhang Ruishan, Lu Yang, Li Hua, Lu Ping, Yao Fan, Jin Feng, Xu Huimian, Wang Shubao, Chen Junqing
Department of Oncology, First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China.
Surg Oncol. 2010 Mar;19(1):4-10. doi: 10.1016/j.suronc.2008.10.003. Epub 2008 Nov 29.
Lymphatic vessel invasion is an important prognostic factor for the gastric cancer without lymph node metastasis. However, the studies on early gastric cancers is still sparse. Therefore, we carried out this study to determine clinicopathological and surgical prognostic factors, especially lymphatic vessel invasion, for early gastric cancers.
Clinicopathological characteristics and prognostic outcomes of 188 patients who received a gastrectomy for early gastric cancer between 1980 and 2000 were retrospectively evaluated based on the subclassification of pN category. A multivariate analysis was performed by using the Cox regression model, where lymphatic vessel invasion and other potential prognostic factors were included.
Of the 188 patients, 158 had T1N0M0 and 30 T1N1M0 cancers. In patients with T1N0M0 cancers, the survival rate was significantly lower in those with lymphatic vessel invasion than in those without (chi(2)=4.025, P=0.045). However, in patients with T1N1M0 cancers, the survival rates were not significantly different between those with and those without lymphatic vessel invasion (chi(2)=0.253, P=0.615). The multivariate analysis identified that age (P=0.033) and lymph node metastasis (P=0.019) were independent prognostic factors for all early gastric cancers. However, age (P=0.042), tumor location (P=0.032), and lymphatic vessel invasion (P=0.010) were the independent prognostic factors for T1N0M0 cancers.
Lymphatic vessel invasion was an independent prognostic factor for T1N0M0 early gastric cancers, and thus may be a potential prominent factor that should be considered to be included in the category of lymphoid metastasis (both lymph node metastasis and lymphatic vessel invasion) in patients with early gastric cancer.
淋巴管侵犯是无淋巴结转移的胃癌的一个重要预后因素。然而，关于早期胃癌的研究仍然较少。因此，我们开展了这项研究以确定早期胃癌的临床病理和手术预后因素，尤其是淋巴管侵犯情况。
回顾性评估了1980年至2000年间因早期胃癌接受胃切除术的188例患者的临床病理特征和预后结果，基于pN分类进行亚分类。采用Cox回归模型进行多因素分析，纳入淋巴管侵犯及其他潜在预后因素。
188例患者中，158例为T1N0M0癌，30例为T1N1M0癌。在T1N0M0癌患者中，有淋巴管侵犯者的生存率显著低于无淋巴管侵犯者（χ²=4.025，P=0.045）。然而，在T1N1M0癌患者中，有淋巴管侵犯者与无淋巴管侵犯者的生存率无显著差异（χ²=0.253，P=0.615）。多因素分析确定年龄（P=0.033）和淋巴结转移（P=0.019）是所有早期胃癌的独立预后因素。然而，年龄（P=0.042）、肿瘤部位（P=0.032）和淋巴管侵犯（P=0.010）是T1N0M0癌的独立预后因素。
淋巴管侵犯是T1N0M0早期胃癌的独立预后因素，因此可能是早期胃癌患者淋巴转移（包括淋巴结转移和淋巴管侵犯）分类中应考虑纳入的一个潜在重要因素。
