The Relationship Between The Lymph Node Metastasis And The Clinicopathological Factors In Early Gastric Cancer

Objective: Summed up the relationship among the lymph node metastasis(LNM)and clinicopathologic factors to guide early gastric cancer(EGC) select theappropriate surgical, approach to improve the quality of patients，life aftersurgery.Methods: Methods of a retrospective study, from January2007to september30th2013,214early gastric cancer patients underwent surgery and was pathologicallydiagnosed as early gastric cancer in the First People’s Hospital of Chenzhou.Collected their clinical characteristics, pathologic features, Including: Sex,age, tumor size, tumor location, general type, depth of invasion, histologicalclassification,vascular infiltration, lymph node-positive number and so on.Detection of early gastric cancer peritumoral lymphatic microvessel density(LMVD) using immunohistochemical staining SP, comparison peritumoral LMVD ofearly gastric cancer with lymph node metastasis and without lymph nodemetastasis, to analysis the relationship among peritumoral LMVD and lymph nodemetastasis.The collected data using SPSS13.0statistical software forstatistical analysis, Comparison of lymph node metastasis and clinicopathologicfactors of early gastric cancer. Measurement data using t test, univariateanalysis is used the chi-square test, multivariate analysis using a BinaryLogistic regression analysis, P <0.05was statistically significant.Results: There are214patients of early gastric cancer, accounting for9.6%of patients with gastric cancer the same period.27cases of patients with lymphnode metastasis, lymph node metastasis rate was12.6%. Altogether1220lymphnodes detected, which detected86positive lymph nodes (7.1%). Univariateanalysis display that general type of tumor affecting factors of lymph nodemetastasis(P=0.015), When tumor invasion into the submucosa lymph node metastasis was significantly increased(P <0.001), with the increase of thetumor, lymph node metastasis was significantly increased(P=0.003), scoresof undifferentiated carcinoma type of cancer lymph node metastasis rate(P=0.033), factors that affect vascular infiltration of lymph node metastasis(P<0.001). Multiple regression analysis display that depth of invasion,tumor size,histological classification, and vascular infiltration are factors of lymphnode metastasis(P <0.05). Further refinement of the tumor size analysis, Whenthe tumor is larger than the diameter of3cm, the factors affecting the sizeof the tumor node metastasis(P=0.009). Its the most for lymph node metastasisto group3in upper and middle cancer, the most to groups6in lower cancer,second, each group higher lymph node transfer rate to group7. Mucosal layerof differentiated and undifferentiated carcinoma were84cases as the diameter≤2cm(39.3%),2～3cm differentiated carcinoma of the total4cases(1.9%),thereis not lymph node metastasis, undifferentiated carcinoma of2～3cm total18cases(8.4%),2cases of lymph node metastasis(7.4%). Submucosa of differentiatedcarcinoma as as the diameter≤2cm with no lymph node metastasis, the diameter≤2cm of undifferentiated carcinoma of28cases(13.1%),8cases of lymph nodemetastasis(29.6%), Differentiated and undifferentiated carcinoma as thediameter2～3cm of lymph node metastasis. The early gastric cancer with lymphnode metastasis for peritumoral LMVD is significantly higher than that withoutlymph node metastasis(P <0.001). Tumor invasion to the submucosa peritumoralLMVD is higher than invasion to the mucosa(P <0.001). Tumor diameter2～4cm LMVDperitumoral LMVD is higher than Tumor diameter≤2cm(P <0.001). The degree oftumor differentiation is undifferentiated peritumoral LMVD is higher thandifferentiated(P=0.014). There vascular invasion peritumoral LMVD is higherthan no vascular invasion(P=0.007).Conclusion:1，Depth of invasion of early gastric cancer, tumor size,histological classification, vascular infiltration are the factors of lymphnode metastasis.2，The following pathological factors of early gastric cancerlymph node metastasis rate are lower (1) Mucosa cancer, the diameter≤3cm, differentiated.(2) Mucosa cancer, the diameter≤2cm, undifferentiated.(3)Submucosal carcinoma, the diameter≤2cm, differentiated.3,Early gastriccancer high peritumoral LMVD is the risk factors of lymph node metastasis. Depthof invasion of early gastric cancer, tumor size, level of differentiation,vascular invasion correlated with LMVD.