Analysis Of Risk Factors In LVI Of Gastric Caner

Objective: The aim of this study was to investigate the risk factors of gastric cancer with lymphatic vascular invasion(LVI).Methods :Gastric adenocarcinoma patients,registered in general surgery department of Dalian Medical University from 2012.1 to 2014.12,in stage I-III were analysed,retrospectively.C linopathological information,such as age,gender,tumor size,location,differentiation type,tumor gross type,lymph node metastasis(LM),number of metastastic lymph nodes,depth of invasion,N stage and TNM stage were analysed.All patients were divided into two groups according to LVI.Chi square test,rank sum test and multivariate logistic regression method was used to study the risk factors of LVI.Spss19.0 were used for data processing.Results:212 patients within 158 male and 54 female we re recruited.Among them,82 patients were in LVI(+)group,130 patients in LVI(-)group.The total incidence of LVI was 38.6%.Statistical analysis showed that there was no significant difference among age,gender,tumor location,CA125,AFP,CA19-9 and CEA(p >0.05).Tumor size,differentiation type,tumor gross type,lymph node metastasis,number of metastastic lymph nodes,depth of invasion,N stage and TNM stage were statistically significant(p <0.05).There was significant difference in tumro size between these two groups(4.0cm,range 2.5cm-6.5cm,2.6cm,range 2.5cm-6.5cm respectively,p=0.019).The incidence of LVI was 25%,44% in middle-high and low differentiation types,respectively.There was significance between them(p=0.004).poor differentiation was a risk factor of LVI.The rate of LVI would increased with the depth of invasion.When the tumor infilated deeper than gastric muscular layer,the rate of LVI was 46.8% and 28% as for the depth less than gastric muscular layer(p<0.05).91 patients were found in LVI(-)/LM(-)group,8 in LVI(+)/LM(-)group,45 in LVI(-)/LM(+)group,68 in LVI(+)/LM(+)group when analysed by packet parsing of LVI according to LM.No significant difference was found in the comparison between LVI(-)/LM(-)group and LVI(+)/LM(-)group.There was statistically significant in differentiation type,N stage and number of metastatic lymph nodes between LVI(+)/LM(+)group and LVI(-)/LM(+)group.Median of metastatic lymph nodes between group LVI(+)/LM(+)and LVI(-)/LM(+)were 11.5(range 3-15)and 5(range 3.5-7),respectively.When LVI occurred,metastatic lymph nodes would increased.N umber of metastastic lymph nodes,lymph node metastasis TNM staging were independent risk factors of LVI by multivariate analysis of these factors(OR=1.462 p=0.000;OR=1.120 p=0.002;OR=3.281 p=0.012,respectively).Conclusion: Tumor size,differentiation type,tumor gross type,LM,number of metastastic lymph nodes,depth of invasion,N stage and TNM stage were risk factors of LVI by univariate analysis.Number of metastastic lymph nodes,LM and TNM staging were independent risk factors of LVI by multivariate analysis of these factors.LVI could be a prognostic factor of gastric cancer.LVI and TM related closely.With the occurance of LVI,number of metastastic lymph nodes also increased.