早期低分化型胃癌淋巴结转移的危险因素与腹腔镜局部切除术的探讨  

Risk Factors of Lymph Node Metastasis and Laparoscopic Wedge Resection in Early Poorly Differentiated Gastric Cancer

作　　者：霍志斌[1] 吴殿超[1] 李华[1] 翟同善[1] 栾尚峰[1] 穆炳阁[1] 王淑霞[1] 郭淑静[1] 

机构地区：[1]河北医科大学附属邢台市人民医院肿瘤外二科,河北省邢台市054001

出　　处：《中国肿瘤临床》2012年第19期1418-1419,1425,共3页Chinese Journal of Clinical Oncology

基　　金：邢台市科学基金(编号;20102025-2)资助~~

摘　　要：目的:探讨早期低分化型胃癌淋巴结转移的危险因素,从而对早期低分化型胃癌患者,行腹腔镜下局部切除术提供理论依据。方法:回顾性分析80例早期低分化型胃癌的临床病理资料,按照临床病理特征与淋巴结转移的关系进行统计学分析。结果:通过多因素分析,肿瘤大小≥2cn,黏膜下癌和淋巴管癌栓阳性对淋巴结转移有统计学意义(P<0.05)。无危险因素的患者,淋巴结转移率为0;三个危险因素都具有者,淋巴结转移率高达42.9%。结论:肿瘤大小≥2 cm,黏膜下癌和淋巴管癌栓阳性是早期低分化型胃癌淋巴结转移的独立危险因素对于早期低分化型胃癌患者,行腹腔镜下局部切除术,这三项危险因素是判断是否进行附加手术的简单标准。Objective： This study aimed to identify the clinicopathological factors that are predictive of lymph node metastasis （LNM） in poorly differentiated early gastric cancer （PDEGC）, and to increase the possibility of using laparoscopic wedge resection for treating patients with PDEGC. Methods： Clinical data of 80 patients with PDEGC who underwent surgery were collected. The associa- tion between clinicopathological factors and LNM was retrospectively analyzed by univariate and multivariate logistic regression analy- ses. Results： Univariate analysis showed that the tumor size, depth of invasion, and lymphatic vessel involvement （LVt） were the signif- icant and independent risk factors of LNM. The LNM rate reached 42.9% in cases with all three risk factors, i.e., tumor size ≥ 2 cm, submucosal carcinoma, and positive cancer embolus of lymphatic vessels. Among all 80 patients, LNM was not found in 25 without the three clinicopathological risk factors. Conclusion： Laparoscopic wedge resection alone may be sufficient to treat intramucosal PDEGC if the tumor size is ≤ 2.0 cm and if LVI is absent in the postoperative histological examination.

关 键 词：早期胃癌淋巴结转移 临床病理特征腹腔镜局部切除术 

分 类 号：R735.2[医药卫生—肿瘤]