Clinical analysis of influence factors for lymph node metastasis of early gastric cancer patients_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Yinzhong , ZHANG Yanping ,  HAN Chaoyang , FU Yanzhong , WANG Juan

Department of General Surgery Area 1, The First Affiliated Hospital of Henan Polytechnic University, The Second People’s Hospital of Jiaozuo, Jiaozuo, Henan 454000, P.R.China;

Corresponding author：

HAN Chaoyang, Email: dhcy@126.com

Keywords：

early gastric cancer; lymph node metastasis; influence factor

DOI：

10.7507/1007-9424.201607007

Video：

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Objective To explore the clinicopathological characteristics which were associated with lymph node metastases in early gastric cancer patients. Methods Clinical data of 187 early gastric cancer patients who received surgical treatment in The Second People’s Hospital of Jiaozuo between January 2009 and January 2016, were retrospectively analyzed, and then exploring the clinicopathological characteristics which were associated with lymph node metastases in early gastric cancer, including age, gender, tumor location, diameter of tumor, number of tumor, depth of invasion, macroscopic type, histological type, venous invasion, and local ulcer. Results In this study, 187 patients with early gastric cancer were included, and lymph node metastasis was detected in 32 patients (17.1%). Results of multivariate logistic regression analysis showed that, lymph node metastasis was significantly closely related with diameter of tumor (OR=2.080,P=0.022), depth of invasion (OR=21.048,P=0.001), histological type (OR=3.507,P=0.018), venous invasion (OR=2.406,P=0.009), and local ulcer (OR=2.738,P=0.001), patients with diameter of tumor larger than 2 cm, infiltration depth of submucosa, histological types of undifferentiated type, vascular infiltration, and local ulcer had higher lymph node metastasis rate. Conclusion The clinicopathological characteristics, including diameter of tumor, depth of invasion, histological type, venous invasion, and local ulcer are risk factors for lymph node metastasis of early gastric cancer patients, which should be paid high attention.

Citation： WANG Yinzhong, ZHANG Yanping, HAN Chaoyang, FU Yanzhong, WANG Juan. Clinical analysis of influence factors for lymph node metastasis of early gastric cancer patients. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(3): 328-332. doi: 10.7507/1007-9424.201607007 Copy

1.	李诚, 周健, 裘炯良. 胃癌流行病学与分子生物学病因的研究进展. 肿瘤防治研究, 2004, 31(2): 115-118.
2.	李华, 霍志斌, 吴殿超, 等. 内镜下治疗未分化型早期胃癌的临床研究. 中国肿瘤临床, 2015, 42(19): 969-972.
3.	罗来斌, 黄湖南, 郑马亮, 等. 早期胃癌患者淋巴结转移的危险因素分析. 实用临床医学(江西), 2013, 14(3): 46-48.
4.	Wang Y. The predictive factors for lymph node metastasis in early gastric cancer: a clinical study. Pak J Med Sci, 2015, 31(6): 1437-1440.
5.	何新阳, 邵峰, 梁伟, 等. 215例早期胃癌淋巴结转移的危险因素分析. 中国肿瘤临床, 2013, 40(2): 97-99.
6.	Hirasawa T, Gotoda T, Miyata S,et al. Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiatedtype early gastric cancer. Gastric Cancer, 2009, 12(3): 148-152.
7.	Feng XY, Wang W, Luo GY,et al. Comparison of endoscopic ultrasonography and multislice spiral computed tomography for the preoperative staging of gastric cancer-results of a single institution study of 610 Chinese patients. PLoS One, 2013, 8(11): e78846.
8.	郑瑞, 聂明明, 张新, 等. 早期胃癌淋巴结转移与临床病理因素关系的临床研究. 中华普外科手术学杂志(电子版), 2012, 6(2): 18-20.
9.	Abe N, Watanabe T, Suzuki K,et al. Risk factors predictive of lymph node metastasis in depressed early gastric cancer. Am J Surg, 2002, 183(2): 168-172.
10.	Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma-2nd English edition. Gastric Cancer, 1998, 1(1): 10-24.
11.	苗儒林, 李子禹, 季加孚. 早期胃癌的规范化治疗. 中国普外基础与临床杂志, 2014, 21(1): 16-20.
12.	涂朝勇, 朱锦德, 邵初晓, 等. 影响早期胃癌淋巴结转移的临床病理因素分析. 浙江实用医学, 2011, 16(5): 336-338.
13.	Kim KJ, Park SJ, Moon W,et al. Analysis of factors related to lymph node metastasis in undifferentiated early gastric cancer. Turk J Gastroenterol, 2011, 22(2): 139-144.
14.	Shen L, Huang Y, Sun M,et al. Clinicopathological characteristics associated with lymph node metastasis in early gastric cancer with submucosal invasion. Chinese J Pract Surg, 2012, 29(1): 91-93.
15.	张顽军, 潘文胜, 许晶虹, 等. 早期胃癌淋巴转移临床病理因素探讨. 实用肿瘤杂志, 2010, 25(5): 553-556.
16.	孟祥彩. 早期胃癌淋巴结转移危险因素分析. 石家庄: 河北医科大学, 2014: 31-35.
17.	张丹杰, 车向明, 李海军, 等. 胃癌组织学类型与预后的关系. 中国普外基础与临床杂志, 2011, 18(5): 545-548.
18.	Lee JH, Nam BH, Ryu KW,et al. Tumor differentiation is not a risk factor for lymph node metastasis in elderly patients with early gastric cancer. Eur J Surg Oncol, 2014, 40(12): 1771-1776.
19.	毕铁男, 冯杏君, 兰跃福, 等. 老年与青年早期胃癌淋巴结转移危险因素对比分析. 中华全科医学, 2013, 11(11): 1673-1675.
20.	蒋志凌, 邓桂英. 早期胃癌临床病理特征与浸润深度的关系. 华西医学, 2014, 29(11): 2050-2054.
21.	Ren G, Cai R, Zhang WJ,et al. Prediction of risk factors for lymph node metastasis in early gastric cancer. World J Gastroenterol, 2013, 19(20): 3096-3107.
22.	于会生, 王九菊, 刘松玲, 等. 上海、洛阳两地胃癌发生部位分析. 河南肿瘤学杂志, 2002, 15(4): 253-255.
23.	Yamamoto S, Nishida T, Kato M,et al. Evaluation of endoscopic ultrasound image quality is necessary in endosonographic assessment of early gastric cancer invasion depth. Gastroenterol Res Pract, 2012, 2012: 194530.
24.	朱敏, 李明阳, 吴本俨. 早期胃癌内镜下切除术后复发的相关因素分析. 中华内科杂志, 2011, 50(5): 366-369.

1. 李诚, 周健, 裘炯良. 胃癌流行病学与分子生物学病因的研究进展. 肿瘤防治研究, 2004, 31(2): 115-118.
2. 李华, 霍志斌, 吴殿超, 等. 内镜下治疗未分化型早期胃癌的临床研究. 中国肿瘤临床, 2015, 42(19): 969-972.
3. 罗来斌, 黄湖南, 郑马亮, 等. 早期胃癌患者淋巴结转移的危险因素分析. 实用临床医学(江西), 2013, 14(3): 46-48.
4. Wang Y. The predictive factors for lymph node metastasis in early gastric cancer: a clinical study. Pak J Med Sci, 2015, 31(6): 1437-1440.
5. 何新阳, 邵峰, 梁伟, 等. 215例早期胃癌淋巴结转移的危险因素分析. 中国肿瘤临床, 2013, 40(2): 97-99.
6. Hirasawa T, Gotoda T, Miyata S,et al. Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiatedtype early gastric cancer. Gastric Cancer, 2009, 12(3): 148-152.
7. Feng XY, Wang W, Luo GY,et al. Comparison of endoscopic ultrasonography and multislice spiral computed tomography for the preoperative staging of gastric cancer-results of a single institution study of 610 Chinese patients. PLoS One, 2013, 8(11): e78846.
8. 郑瑞, 聂明明, 张新, 等. 早期胃癌淋巴结转移与临床病理因素关系的临床研究. 中华普外科手术学杂志(电子版), 2012, 6(2): 18-20.
9. Abe N, Watanabe T, Suzuki K,et al. Risk factors predictive of lymph node metastasis in depressed early gastric cancer. Am J Surg, 2002, 183(2): 168-172.
10. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma-2nd English edition. Gastric Cancer, 1998, 1(1): 10-24.
11. 苗儒林, 李子禹, 季加孚. 早期胃癌的规范化治疗. 中国普外基础与临床杂志, 2014, 21(1): 16-20.
12. 涂朝勇, 朱锦德, 邵初晓, 等. 影响早期胃癌淋巴结转移的临床病理因素分析. 浙江实用医学, 2011, 16(5): 336-338.
13. Kim KJ, Park SJ, Moon W,et al. Analysis of factors related to lymph node metastasis in undifferentiated early gastric cancer. Turk J Gastroenterol, 2011, 22(2): 139-144.
14. Shen L, Huang Y, Sun M,et al. Clinicopathological characteristics associated with lymph node metastasis in early gastric cancer with submucosal invasion. Chinese J Pract Surg, 2012, 29(1): 91-93.
15. 张顽军, 潘文胜, 许晶虹, 等. 早期胃癌淋巴转移临床病理因素探讨. 实用肿瘤杂志, 2010, 25(5): 553-556.
16. 孟祥彩. 早期胃癌淋巴结转移危险因素分析. 石家庄: 河北医科大学, 2014: 31-35.
17. 张丹杰, 车向明, 李海军, 等. 胃癌组织学类型与预后的关系. 中国普外基础与临床杂志, 2011, 18(5): 545-548.
18. Lee JH, Nam BH, Ryu KW,et al. Tumor differentiation is not a risk factor for lymph node metastasis in elderly patients with early gastric cancer. Eur J Surg Oncol, 2014, 40(12): 1771-1776.
19. 毕铁男, 冯杏君, 兰跃福, 等. 老年与青年早期胃癌淋巴结转移危险因素对比分析. 中华全科医学, 2013, 11(11): 1673-1675.
20. 蒋志凌, 邓桂英. 早期胃癌临床病理特征与浸润深度的关系. 华西医学, 2014, 29(11): 2050-2054.
21. Ren G, Cai R, Zhang WJ,et al. Prediction of risk factors for lymph node metastasis in early gastric cancer. World J Gastroenterol, 2013, 19(20): 3096-3107.
22. 于会生, 王九菊, 刘松玲, 等. 上海、洛阳两地胃癌发生部位分析. 河南肿瘤学杂志, 2002, 15(4): 253-255.
23. Yamamoto S, Nishida T, Kato M,et al. Evaluation of endoscopic ultrasound image quality is necessary in endosonographic assessment of early gastric cancer invasion depth. Gastroenterol Res Pract, 2012, 2012: 194530.
24. 朱敏, 李明阳, 吴本俨. 早期胃癌内镜下切除术后复发的相关因素分析. 中华内科杂志, 2011, 50(5): 366-369.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical analysis of influence factors for lymph node metastasis of early gastric cancer patients

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