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.
Objective To investigate pattern of lymph node metastasis (LNM) in patient with early gastric cancer (EGC) and it’s relation to clinicopathologic features so as to providing evidence for proper clinical management for EGC. Method The clinical and pathologic data of 101 EGC patients who were diagnosed and treated in the West China Hospital of Sichuan University from January 2011 to December 2012 were retrospectively analyzed. Results The LNM was found in the 28 patients, the rate of the LNM was 27.7% (28/101). In the univariate analysis, the LNM was associated with the macroscopic type (P=0.013), depth of invasion (P<0.001), differentiation type (P=0.044), and lymphovascular invasion (P=0.020); In the multivariate logistic regression analysis, the factors including of the macroscopic type (RR=4.742, P=0.009), differentiation type (RR=6.369, P=0.011), and depth of invasion (RR=15.218, P<0.001) were the independent risk factors for the LNM. Twenty-eight patients with LNM had only 1 positive lymph node, 4 patients had more than 7 positive lymph nodes. The No.6 lymph node was the most frequently involved station (35.7%, 10/28). The LNMs in the 69.7% (19/28) patients were restricted in the extent of the D1 lymphadenectomy, 3 (10.7%) patients without the perigastric lymph node involvement had the No.8a or No.9 LNM. Conclusion LNM in patient with EGC is correlated with clinicopathologic features such as macroscopic type, depth of invasion, differentiation type, and lymphovascular, further investigation is warranted to clarify risk factors of LNM in patient with EGC.
Objective To analyze risk factors of lymphatic metastasis in early gastric cancer in order to discuss reasonable therapeutic regimen. Methods The clinical data of 148 patients with early gastric cancer surgically treated in the Anhui Tumor Hospital from February 2013 to November 2017 were retrospectively analyzed. The relationship between the lymphatic metastasis with the clinicopathologic characteristics of the patient with the early gastric cancer was analyzed by the univariate and multiple regression analyses. Results The lymphatic metastasis were observed in 15 of 148 patients (10.14%), 1 in the 70 (1.43%) mucosal lesions and 14 in the 78 (17.95%) submucosal lesions. The results of the univariate analysis showed that the patients’ age, size of tumor, macroscopic type, invasion depth, and vascular invasion were related to the lymphatic metastasis in the early gastric cancer (P<0.050), the results of the multiple regression analysis showed that the invasion depth and vascular invasion were the independent risk factors of the lymphatic metastasis in the early gastric cancer (P<0.050). Conclusions Invasion depth and vascular invasion are closely related to lymphatic metastasis in early gastric cancer. Precise evaluation of lymphatic metastasis before treatment is very important to patient with early gastric cancer.
ObjectiveTo investigate the risk factors of lymph node metastasis for early distal gastric signet ring cell cancer and indications of radical surgery.MethodsFrom Mar. 2013 to Nov. 2018, a total of 91 early gastric cancer patients who accepted radical gestrectomy and regional lymph node dissection, and proved postoperatively for early distal gastric signet ring cell cancer in the First Affiliated Hospital of Soochow University were enrolled in this study. We collected clinicpathologic characteristics, such as gender, age, maximum diameter of tumor, number of lesions, depth of invasion, macroscopic type, and lymphovascular invasion, to explore the risk factors of lymph node metastasis and further analyze the indication of radical surgery.ResultsAll 91 patients accepted radical gestrectomy and regional lymph node dissection, 10 patients suffered from lymph node metastasis. Univariate analysis showed a positive relationship between maximum diameter of tumor (χ2=5.631, P=0.025), depth of invasion (χ2=4.389, P=0.016), number of lesions (χ2=5.615, P=0.023), and lymphovascular invasion (χ2=22.500, P=0.001) and lymph node metastasis of early distal gastric signet ring cell cancer. The multivariate analysis revealed that maximum diameter of tumor (OR=3.675, P=0.012), depth of invasion (OR=3.886, P=0.015), and lymphovascular invasion (OR=8.711, P<0.001) were independent risk factors of lymph node metastasis.ConclusionsThe risk of lymph node metastasis of early distal gastric signet ring cell cancer was high in those with tumor diameter≥2 cm, submucosal cancer, and lymphovascular invasion. Radical surgery might be necessary in cases of early distal gastric signet ring cell cancer that satisfying one of the following criteria: tumor diameter≥2 cm and lymphovascular invasion.
ObjectiveTo explore the risk factors of lymph node metastasis (LNM) in patients with early gastric cancer (EGC), and try to establish a risk prediction model for LNM of EGC.MethodsThe clinicopathologic data of EGC patients who underwent radical gastrectomy and lymph node dissection from January 1, 2015 to December 31, 2019 in this hospital were retrospectively analyzed. Univariate analysis and logistic regression analysis were used to determine the risk factors for LNM of EGC, and the risk prediction model for LNM of EGC was established based on the multivariate results.ResultsA total of 311 cases of EGC were included in this study, and 60 (19.3%) cases had LNM. Univariate and multivariate analysis showed that age (younger), depth of tumor invasion (submucosa), vascular invasion, and undifferentiated carcinoma were the risk factors for LNM of EGC (P<0.05). The optimal threshold for predicting LNM of EGC was 0.158 (area under the receiver operating characteristic curve was 0.864), the sensitivity was 80.0%, and the specificity was 79.3%.ConclusionsFrom results of this study, risk factors for LNM of EGC have age, depth of invasion, vascular invasion, and differentiation degree. Risk prediction model for LNM of EGC established on this results has high sensitivity and specificity, which could provide some references for treatment strategy of EGC.
With the promotion of health awareness and the improvement of gastroscopy examination technology, the detection rate of early gastric cancer in our country had gradually increased. The early gastric cancer had a favorable prognosis and long-term survival. Improving the postoperative quality of life of patients with early gastric cancer had become one of the important directions in gastric cancer research. Under the premise of ensuring tumor radical resection, preserving partial gastric remnant function had become a hot topic in the treatment of early gastric cancer. Function preserving gastrectomy for early gastric cancer mainly included segmental gastrectomy, proximal gastrectomy, and local gastrectomy, among others. The author summarized the important research progress in function preserving gastrectomy at home and abroad in recent years, as well as the practical experiences of this center, aiming to provide reference for clinical surgeons to better carry out this type of surgery.