Bravo Neto Guilherme Pinto, dos Santos Elizabeth Gomes, Victer Felipe Carvalho, Carvalho Carlos Eduardo de Souza
Departament of Surgery, Faculty of Medicine, UFRJ.
Clementino Fraga Filho Universitary Hospital, UFRJ.
Rev Col Bras Cir. 2014 Jan-Feb;41(1):11-7. doi: 10.1590/s0100-69912014000100004.
to evaluate the incidence of lymph node metastasis in early gastric cancer, identifying risk factors for its development.
we conducted a prospective study of patients with gastric cancer admitted to the Section of the Esophago-Gastric Surgery of the Surgery of Service HUCFF-UFRJ, from January 2006 to May 2012.
the rate of early gastric cancer was 16.3%. The incidence of nodal metastases was 30.8% and occurred more frequently in patients with tumors with involvement of the submucosa (42.9%), in those poorly differentiated (36.4%), in tumors larger than 2 cm (33.3%) and in type III ulcerated lesions (43.8%).
the incidence of lymph node metastases in patients was very high and suggests that one should keep the radicality of resection in early gastric cancer, particularly in relation to D2 lymphadenectomy, recommended for advanced gastric cancer. Conservative resections, with lymphadenectomies smaller than D2, should be performed only in selected cases, well-studied as for the risk factors of lymph node metastasis. Despite the small number of cases did not permit to relate the rate of lymph node metastasis to the risk factors considered, we noted a strong tendency for the occurrence of these metastases in the poorly differentiated, type III, larger than 2 cm tumors, and in the Lauren diffuse types.
评估早期胃癌淋巴结转移的发生率，确定其发生的危险因素。
对2006年1月至2012年5月入住胡斯夫-里约热内卢联邦大学外科食管胃外科的胃癌患者进行了一项前瞻性研究。
早期胃癌的发生率为16.3%。淋巴结转移的发生率为30.8%，在肿瘤侵犯黏膜下层的患者中更常见（42.9%），在低分化患者中（36.4%），在肿瘤大于2 cm的患者中（33.3%）以及在III型溃疡病变患者中（43.8%）。
患者淋巴结转移的发生率非常高，这表明对于早期胃癌应保持切除的根治性，特别是对于晚期胃癌推荐的D2淋巴结清扫术。仅在经过充分研究淋巴结转移危险因素的特定病例中，才应进行小于D2的淋巴结清扫的保守性切除。尽管病例数量较少，无法将淋巴结转移率与所考虑的危险因素相关联，但我们注意到在低分化、III型、大于2 cm的肿瘤以及劳伦弥漫型肿瘤中，这些转移的发生有很强的趋势。
