内镜下治疗未分化型早期胃癌的临床研究  

Endoscopic therapy in undifferentiated early gastric cancer

作　　者：李华[1] 霍志斌[1] 吴殿超[1] 翟同善[1] 肖琦海[1] 王淑霞[1] 张丽丽[1] 

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

出　　处：《中国肿瘤临床》2015年第19期969-972,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨未分化型早期胃癌淋巴结转移的危险因素,从而对未分化型早期胃癌患者行内镜下治疗提供理论依据。方法:回顾性分析河北医科大学附属邢台市人民医院肿瘤外科1996年1月至2008年12月90例未分化型早期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>2 cm,淋巴管癌栓和黏膜下癌对淋巴结转移的差异具有统计学意义(P<0.05)。无危险因素的患者,淋巴结转移率为0;3个危险因素均有者,淋巴结转移率高达57.1%。结论:肿瘤大小>2 cm,存在淋巴管癌栓和黏膜下癌是未分化型早期胃癌淋巴结转移的独立危险因素。对于无危险因素的患者,行内镜下切除是可行的。Objective： To investigate the clinicopathological factors predictive of lymph node metastasis （LNM） in undifferentiat- ed early gastric cancer （EGC） and to expand the possibility of endoscopic therapy for treating undifferentiated EGC.Methods： The re- searchers collected the data of 90 undifferentiated EGC patients who had undergone surgery at the Xingtai People＇s Hospital, Xingtai, China. The relationship between LNM and clinicopathological factors was retrospectively analyzed using univariate and multivariate lo- gistic regression analyses. Results： Univariate analysis showed that tumor size, lymphatic vessel involvement （LVI）, and cancer inva- sion depth were the significant and independent risk factors for LNM. The LNM rate was 57.1% in patients with the three clinicopatho- logical risk factors. LNM was not found in patients without the three risk factors. Conclusion： Tumor size, LVI, and invasion depth are independently associated with the presence of LNM in undifferentiated EGC. Endoscopic therapy can be used to treat the patients with- out risk factors.

关 键 词：早期胃癌 淋巴结转移 临床病理特征 内镜下黏膜切除术 内镜黏膜下剥离术 

分 类 号：R735.2[医药卫生—肿瘤]