早期胃癌淋巴结转移相关的临床病理特征：来自中国单中心经验的分析
Clinicopathological features associated with lymph node metastasis in early gastric cancer: analysis of a single-institution experience in China.
作者信息
Shen Lizong, Huang Yiming, Sun Maocai, Xu Hao, Wei Wei, Wu Wenxi
机构信息
First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
出版信息
Can J Gastroenterol. 2009 May;23(5):353-6. doi: 10.1155/2009/462678.
BACKGROUND
An accurate assessment of potential lymph node metastasis is an important issue for the appropriate treatment of early gastric cancer. Minimizing the number of invasive procedures used in cancer therapy is critical for improving the patient's quality of life.
OBJECTIVE
To evaluate the clinicopathological features associated with lymph node metastasis of early gastric cancer in patients from a single institution in China.
METHODS
A retrospective review of data from 410 patients surgically treated for early gastric cancer at the First Affiliated Hospital (Nanjing, China) between 1998 and 2007, was conducted. The clinicopathological variables associated with lymph node metastasis were evaluated.
RESULTS
Lymph node metastasis was observed in 12.20% of patients. The macroscopic type, tumour size, location in the stomach, depth of gastric carcinoma infiltration, and presence of vascular or lymphatic invasion showed a positive correlation with the incidence of lymph node metastasis by univariate analysis. Multivariate analyses revealed histological classification, macroscopic type, tumour size, depth of gastric carcinoma infiltration, and the presence of vascular or lymphatic invasion to be significantly and independently related to lymph node metastasis. The depth of gastric carcinoma infiltration was the strongest predictive factor for lymph node metastasis. For intramucosal cancer, tumour size was the unique risk factor for lymph node metastasis. For submucosal cancer, histological classification and tumour size were independent risk factors for lymph node metastasis.
CONCLUSIONS
Histological classification, macroscopic type, tumour size, depth of gastric carcinoma infiltration, and the presence of vascular or lymphatic invasion are independent risk factors for lymph node metastasis in patients with early gastric cancer in China. Minimal invasive treatment, such as endoscopic mucosal resection, may be possible for highly selected cancers.
背景
准确评估潜在淋巴结转移是早期胃癌恰当治疗的重要问题。尽量减少癌症治疗中侵入性操作的数量对提高患者生活质量至关重要。
目的
评估中国一家机构中早期胃癌患者淋巴结转移相关的临床病理特征。
方法
对1998年至2007年在中国南京第一附属医院接受手术治疗的410例早期胃癌患者的数据进行回顾性分析。评估与淋巴结转移相关的临床病理变量。
结果
12.20%的患者出现淋巴结转移。单因素分析显示，大体类型、肿瘤大小、胃内位置、胃癌浸润深度以及血管或淋巴管侵犯与淋巴结转移发生率呈正相关。多因素分析显示，组织学分类、大体类型、肿瘤大小、胃癌浸润深度以及血管或淋巴管侵犯与淋巴结转移显著且独立相关。胃癌浸润深度是淋巴结转移的最强预测因素。对于黏膜内癌，肿瘤大小是淋巴结转移的唯一危险因素。对于黏膜下癌，组织学分类和肿瘤大小是淋巴结转移的独立危险因素。
结论
在中国，组织学分类、大体类型、肿瘤大小、胃癌浸润深度以及血管或淋巴管侵犯是早期胃癌患者淋巴结转移的独立危险因素。对于经过严格筛选的癌症，可能可行内镜黏膜切除术等微创治疗。
Zotero 插件