Characteristics Of Lymph Node Metastasis And Analysis On Related Factors Of Advanced Gastric Cancer In Hehuang Valley

Objective To investigate the characteristics and the related factors of lymph node metastasis of advanced gastric cancer in Hehuang Valley,so as to provide theoretical supports for the choice of gastric cancer radical surgical procedures and the decision of lymph node dissection extent in this region.Method This study retrospectively analyzes a total of 204 cases(all of them are Hehuang valley native advanced gastric cancer patients),which accepted gastric cancer radical surgeries in gastrointestinal oncological surgery of Qinghai University Affiliated Hospital during September 2014 to September 2015 with complete operation records and postoperative pathological reports after lymph node dissection,then we count the lymph node metastatic rate and ratio and finally statistically analyze the relationship between perigastric lymph node metastasis and tumor size, T stage, Borrmann classification, tumor site, histological differentiation degree, patient age and gender by using SPSS20.0 software.Results As the tumor diameter is 5cm or bigger than 5cm, the rate and degree of lymph node metastasis are significantly higher than patients with tumor diameter less than 5cm(χ2=23.69,P=0.000;χ2=211.24,P=0.000); With the increase of T stage, the rate and degree of lymph node metastasis are significantly elevated(χ2=38.57,P=0.000;χ2=198.48,P=0.000); The lymph node metastasis rate of gastric cancer patients with Borrmann Ⅲ and Ⅳ types are significantly higher than Borrmann Ⅰ and Ⅱ types(χ2=12.56,P=0.000), and the degree of lymph node metastasis increase in turn with Borrmann Ⅰ, Ⅱ, Ⅲ, Ⅳ types(P=0.000); The rate and degree of lymph node metastasis in gastric cancer patients with poorly-differentiated and undifferentiated type are significantly higher than highly-differentiated and moderately-differentiated type patients(χ2=20.05, P=0.000; χ2=35.61, P=0.000). Nevertheless, the impact of differences in tumor site(except involving the whole stomach), age and gender on lymph node metastasis are not statistically significant respectively.Conclusion Tumor size, T stage, Borrmann classification and histological classification have a great influence on lymph node metastasis of advanced gastric cancer in Hehuang Valley. As tumor diameter is bigger than 5cm, T stage is higher, gross classification is Borrmann Ⅲ or Ⅳ type, tumor differentiates more poorly, the rate and degree of lymph node metastasis are higher. The No.8a and No.14 v lymph nodes tend to metastasize frequently in the lower 1/3 gastric cancer patients and the No.11 p lymph nodes tend to metastasize frequently in the upper 1/3 gastric cancer patients in Hehuang Valley,which we should remove more carefully in gastric cancer D2 radical surgery. Lymph node metastasis has no connection with tumor size, patient age or gender.