胃黏膜内癌的淋巴结转移特点分析  

The clinicopathological features of lymph node metastasis in intramucosal early gastric cancer

作　　者：王征[1] 周志祥[1] 梁建伟[1] 张兴茂[1] 胡俊杰[1] 曾维根[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院腹部外科,北京100021

出　　处：《中国肿瘤临床与康复》2014年第4期440-443,共4页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：首都医学发展科研基金(2011-04002-03)

摘　　要：目的探讨黏膜内早期胃癌(EGC)淋巴结转移的危险因素,为早期胃癌的个体化治疗提供依据。方法对1994年1月至2008年12月间接受根治性D2切除术的212例黏膜内早期胃癌患者的临床病理学资料进行回顾性分析,应用单因素和多因素Logistic回归分析评估影响黏膜内早期胃癌淋巴结转移的危险因素。结果 212例黏膜内早期胃癌患者的淋巴结转移率为3.3%(7/212),其中肿瘤最大径≤2cm和>2cm的淋巴结转移率分别为0.8%和7.5%;分化型与和分化型患者的淋巴结转移率分别为1.4%和7.1%;有脉管瘤栓和无脉管瘤栓患者的淋巴结转移率分别为100.0%和2.4%。多因素分析显示,肿瘤最大径>2cm、未分化型腺癌和脉管瘤栓是黏膜内早期胃癌淋巴结转移的独立危险因素(P<0.05)。结论肿瘤直径≤2cm、分化型腺癌和无脉管瘤栓的黏膜内早期胃癌发生淋巴结转移风险小,可作为制订个体化治疗方案的参考。Objective To analyze the clinicopathological features of lymph node metastasis in in- tramucosal early gastric cancer（EGC）. Methods The clinicopathological data of 212 EGC cases from Jan t994 to Dec 2008 undergone resection were analyzed retrospectively. Results The rate of lymph node me- tastasis in intramueosal EGC was 3.3% （7/212）. Lymph node metastasis was 0. 8% in the size of intramu- cosal EGC smaller and equal to 2cm,7.5% in patients with carcinoma larger than 2cm. The rate of lymph node metastasis was 7.1% in undifferentiated tumors,which was significantly higher than that in differentia- ted tumors（ 1.4% ）. Lymph node metastasis was found in 100. 0% eases with vascular involvement and in 2.4% cases without vascular involvement. The tumor size, histological type of tumor and vascular involve- ment showed a positive correlation with lymph node metastasis in intramucosal EGC by univariate analysis （ P 〈 O. 05 ）. Multivariate analysis revealed that tumor size 〉 2cm, undifferentiated histological type and vas- cular involvement were identified as independent risk factors of lymph node metastasis（P 〈0. 05）. Conclu- sion The risk of lymphatic metastasis of intramueosal EGC was small in those with tumor size≤2em, dif- ferentiated tumors, and without vascular involvement.

关 键 词：早期胃癌 黏膜内癌 淋巴结转移 病理学 外科学 

分 类 号：R735.2[医药卫生—肿瘤]