Li Yu, Wang Dongsheng, Li Yi, Liu Xiaodong, Chen Dong, Yuan Chentong, Zhou Yanbing
Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Gastroenterol Res Pract. 2021 Mar 3;2021:6854646. doi: 10.1155/2021/6854646. eCollection 2021.
To investigate the relationship between lymph node micrometastasis (LNMM) and clinicopathological factors and to evaluate the prognostic effects of LNMM in pN0 gastric cancer (GC) patients.
One hundred and seventy-two GC patients who received radical gastrectomy with D2 lymph node dissection were enrolled in the present study. 1371 negative lymph nodes from level 2 station confirmed by pathology were examined. The LNMM was diagnosed by telomeric repeat amplification protocol/enzyme-linked immunosorbent assay (TRAP-ELISA). The relationship between clinicopathological factors and LNMM was investigated by multivariate analysis. Survival analysis was performed to evaluate the effects of LNMM on prognosis.
LNMM was detected in 423 lymph nodes from 72 patients. The results showed that invasion depth (OR = 3.755, = 0.004), TNM staging (OR = 3.152, = 0.002), lymphatic invasion (OR = 2.178, = 0.009), and tumor differentiation (OR = 1.266, = 0.013) were independent risk factors associated with LNMM. Survival analysis showed that patients with LNMM had significantly worse 5-year survival compared with those without LNMM (42% vs. 76.4%, < 0.05). Multivariate analysis demonstrated that LNMM, tumor size, Lauren type, invasion depth, and lymphatic invasion ( < 0.05) were independently factors associated with 5-year survival.
The findings showed that tumor invasion depth, TNM staging, lymphatic invasion, and tumor differentiation were independent risk factors associated with LNMM occurrence. Moreover, LNMM is a clinically negative prognostic factor in pN0 GC patients.
探讨淋巴结微转移（LNMM）与临床病理因素之间的关系，并评估LNMM对pN0期胃癌（GC）患者预后的影响。
本研究纳入172例行D2淋巴结清扫根治性胃切除术的GC患者。对病理确诊的1371枚来自2站的阴性淋巴结进行检查。采用端粒重复序列扩增法/酶联免疫吸附测定（TRAP-ELISA）诊断LNMM。通过多因素分析研究临床病理因素与LNMM的关系。进行生存分析以评估LNMM对预后的影响。
72例患者的423枚淋巴结检测到LNMM。结果显示，浸润深度（OR = 3.755，P = 0.004）、TNM分期（OR = 3.152，P = 0.002）、淋巴管浸润（OR = 2.178，P = 0.009）和肿瘤分化（OR = 1.266，P = 0.013）是与LNMM相关的独立危险因素。生存分析表明，与无LNMM的患者相比，有LNMM的患者5年生存率显著更差（42%对76.4%，P < 0.05）。多因素分析表明，LNMM、肿瘤大小、Lauren分型、浸润深度和淋巴管浸润（P < 0.05）是与5年生存相关的独立因素。
研究结果表明，肿瘤浸润深度、TNM分期、淋巴管浸润和肿瘤分化是与LNMM发生相关的独立危险因素。此外，LNMM是pN0期GC患者的临床阴性预后因素。
