Clinical And Pathological Features Of Lymph Node Metastasis In Early Gastric Cancer

Background:Lymph node metastasis is the main manner of gastric cancer metastasis.It is also an independent risk factor that affects the treatment and prognosis of early gastric cancer.A number of studies have shown that lymph node metastasis may be related to tumor size,depth of invasion,tumor site,neurovascular invasion,pathological types and so on.However,there are differences between the influencing factors of different reports.This study aims to analyze the risk factors and patterns of lymph node metastasis in early gastric cancer patients,in order to provide evidence for the rational treatment of patients with early gastric cancer.Methods:A retrospective study was performed on the patients with early gastric cancer who underwent surgical resection in Sir Run Run Shaw Hospital from January 1,2014 to December 31,2016.This article aims to analyze the clinical and pathological data to reveal related factors and pattern of early gastric cancer lymph node metastasis.SPSS 20.0 statistical software was used to complete the single factor analysis of the clinical and pathological factors of lymph node metastasis by X2 test,and P<0.05 was statistically significant and t test was used to analyze the quantitative data,P<0.05 was statistically significant.Logistic regression model was used to complete the multiple factors analysis of lymph node metastasis,P<0.05 was statistically significant.Results:There were 319 cases of early gastric cancer postoperative patients.55 cases with lymph node metastasis,264 cases without lymph node metastasis.The overall metastatic rate was 17.24%.Among them,195 cases were male.30 of them were found with lymph node metastasis.The lymph node metastasis rate was 15.38%.124 cases were female.25 of them were found with lymph node metastasis.The lymph node metastasis rate was 20.16%.X2 test,P=0.29,P>0.05,the gender of patients with early gastric cancer lymph node metastasis was not statistically significant factor.The mean age of 55 cases with lymph node metastasis was 57.42±10.87 years old.And the mean age of the 264 cases without lymph node metastasis was 60.88±10.34 years old,P=0.026,P<0.05.There was significant difference in the probability of lymph node metastasis of the age in early gastric cancer.In the aspect of tumor differentiation,the possibility of lymph node metastasis of the differentiated type is lower than that of the poorly differentiated early gastric cancer,P=0.007,P<0.05,The difference was statistically significant.The relativity of tumor location and lymph node metastasis was no statistically significant.While considering the site factors of the greater curvature and the lesser curvature,P=0.849,P>0.05,the difference was not statistically significant.Lymph node metastasis in early gastric cancer located in the greater curvature and lesser curvature had no obvious difference.The invasion depth of early gastric cancer is divided into mucosa and submucosa.The statistical analysis of lymph node metastasis in the mucosa and submucosa was P=0.001,the difference was statistically significant.Submucosal tumors were more likely to have lymph node metastasis.The risk factors of lymph node metastasis in early gastric cancer include the macroscopic classification of tumor,but the difference was statistically significant.On the tumor size,the average size of the tumor of the lymph node metastasis group was 2.89 ± 1.13cm,and the average size of the tumor of no lymph node metastasis group was 2.28 ± 1.22cm,P=0.001.Tumor size was one of the risk factors of lymph node metastasis.According to the diameter of the tumor,the tumor was divided into two groups:greater than 2cm and less than 2cm.X2 test showed P=0.001,which means that the diameter of the tumors larger than 2cm had higher probability of lymph node metastasis.By ROC curve analysis,the cutoff value was 2.45cm.In term of lymph vascular invasion,there were significant differences in lymph node metastasis group and non-lymph node metastasis group.There was a higher probability of vascular invasion in lymph node metastasis group,P<0.001.Multivariate analysis showed that lymph node metastasis was associated with lymph vascular invasion,tumor size and the depth of invasion.Conclusion:The results showed that the lymph node metastatic rate of early gastric cancer was 17.24%.The risk factors of lymph node metastasis include age,the degree of tumor differentiation,tumor size,depth of tumor invasion and lymph vascular invasion.Multivariate analysis showed that lymph vascular invasion,tumor size and depth of invasion were independent risk factors for lymph node metastasis in early gastric cancer.