老年与青年早期胃癌淋巴结转移危险因素对比分析  

Comparative Study on Risk Factors between Young and Elderly Patients with Lymph Node Metastasis of Early Gastric Cancer

作　　者：毕铁男[1] 冯杏君[1] 兰跃福[1] 杨磊磊[1] 董米连[1] 

机构地区：[1]温州医学院附属浙江省台州医院普外科,浙江省临海市317000

出　　处：《中华全科医学》2013年第11期1673-1674,1715,共3页Chinese Journal of General Practice

基　　金：卫生部医药卫生科技项目(W2012FZ006);浙江省医学会临床科研基金项目(2009ZYC50)

摘　　要：目的比较老年与青年早期胃癌(EGC)淋巴结转移的危险因素。方法对经手术治疗的268例老年及130例青年早期胃癌患者的临床病理特征与淋巴结转移的相关性进行回顾性分析。结果青年组较老年组更易发生淋巴结转移(P=0.029),老年早期胃癌淋巴结转移与溃疡情况(P=0.014)、肿瘤大小(P=0.034)、浸润深度(P=0.004)及脉管癌栓(P<0.001)相关,合并有溃疡(P=0.042)、肿瘤浸润至黏膜下层(P=0.019)及有脉管癌栓(P=0.006)是老年EGC淋巴结转移的独立性危险因素;青年EGC淋巴结转移与性别(P=0.013)、分化程度(P=0.021)、浸润深度(P=0.011)及脉管癌栓(P<0.001)相关,女性(P=0.039)、低分化(P=0.048)、肿瘤浸润至黏膜下层(P=0.032)及有脉管癌栓(P=0.012)是青年EGC淋巴结转移的独立性危险因素。结论浸润至黏膜下层及有脉管癌栓是两组患者共同的高危因素,合并有溃疡是老年组的高危因素,女性、低分化是青年组的高危因素。Objective To compare risk factors between young and elderly patients with lymph node metastasis of early gastric cancer（EGC）. Methods The clinicopathological data and lymph node metastasis in 398 patients （268 elderly patients and 130 young patients） with early gastric cancer were retrospectively reviewed. Results Young patients had more chance of lymph node metastasis than elderly patients（ P = 0. 029 ）. To elderly patients with early gastric cancer, univariate analysis revealed correla- tions between lymph node metastasis and various factors ranging from presence of an ulcer（ P = 0.014 ） , tumor size（ P = 01034 ）, depth of invasion （ P = 0. 004 ） to lymphatic involvement （ P 〈 0.001 ）. However, in multivariate analysis, presence of an ulcer （ P = 0. 042）, invasion to the submucosal（ P = 0. 019） ,and lymphatic involvement（P =0.006） were found to be independent risk fac-tors. To young patients with early gastric cancer, univariate analysis revealed correlations between lymph node metastasis and vari-ous factors ranging from patient gender（ P = 0. 013 ）, degree of differentiation（ P = 0. 021 ）, depth of invasion（ P = 0.011 ） to lym-phatic involvement（ P 〈 0.001 ）. In multivariate analysis, female （ P = 0.039 ）, poorly differentiated （ P = 0.048 ）, invasion to the submucosal（ P = 0. 032 ）, and lymphatic involvement（ P = 0. 012） were found to be independent risk factors. Conclusion Young and elderly patients with early gastric cancer shared common risk factors, such as invasion to the submucosal, and lymphatic in-volvement. The main risk factor of the elderly patients was presence of an ulcer. The main risk factors of the young patients were female and poorly differentiated.

关 键 词：早期胃癌 老年 青年 临床病理特征 淋巴结转移 

分 类 号：R735.2[医药卫生—肿瘤] R730.4[医药卫生—临床医学]