Risk Factors Analysis Of Lymph Node Metastasis In Early Gastric Cancer

Objective:To discuss the correlation between lymph node metastasis(LNM)and different clinical and pathological features of early gastric cancer(EGC),and study the influencing factors for LNM.Method:Collect 843 patients from The First Affiliated Hospital Of Nanchang University who had an operation in general surgery department and diagnosed as EGC by postoperative pathological which reference to the Japanese WHO standards from October 2009 to July 2015.Retrospectively the general condition of patients such as age,sex,and the tumor features data including the maximum diameter,position,endoscopic gross morphology,the depth of infiltration,and nerve invasion,tissue differentiation degree,vascular(including blood vessels and lymphatic vessels)presence of tumor emboli,and LNM and so on.Those 843 cases assigned into two groups according to whether merger with LNM,namely the LNM group and the non-LNM group.Using the chi-square test and Logistic regression model analysis of different clinical and pathological characteristics and the correlation between LNM and related risk factors separately.Result:There are 843 cases from The First Affiliated Hospital Of Nanchang University who had an operation in general surgery department and diagnosed as EGC by postoperative pathological from October 2009 to July 2015,with 129 were positive for LNM,whereas 714 were negative for LNM.The result of univariate analyze showed that tumor maximum length,the degree of tissue differentiation,vascular tumor emboli,the depth of infiltration and nerve invasion were associated with LNM in EGC,(x2=19.934,17.620,107.763,37.766,11.428,P=0.000,0.000,0.000,0.000,0.001,P is less than 0.05).Through multiple factors regression analysis indicate that the independent risk factors for LNM including the depth of infiltration,vascular tumor emboli,tumor axis length,undifferentiated type tumor were considered to be pathological risk factors for lymph node metastasis of early gastric cancer(OR=2.107,6.726,1.911,1.730,P=0.000,0.419,0.002,0.013,0.002,and P is less than 0.05).Conclusion:1.There are a variety of clinical and pathological features have a correlation with LNM,while the depth of infiltration,with vascular tumor emboli,size,the differentiation degree of tumor are recognized as the independent risk factors for LNM among the series characteristics in EGC.2.In the numerous factors,lymphatic vessel invasion is the strongest risk factor,followed by infiltration depth.3.Based on these factors,EGC patients with tumor axis length over 2 cm,undifferentiated carcinoma,submucosa invasion and vascular tumor emboli(including blood vessels and lymphatic vessels)need carefully assessed for appropriate treatment,postoperative therapy and closely endoscopic follow-up due to the higher risk of LNM,to evaluate the LNM accurately preoperative,and choose suitable operation method in order to improve the treatment level of EGC and can bring greater benefit to the patient.