Clinicopathological Features And Risk Factors Of Lymph Node Metastasis In Gallbladder Carcinoma

BackgroundCarcinoma of the gallbladder is the most common cancer of the biliary tract and is extremely aggressive.Epidemiological studies have shown that gallbladder cancer has a high risk of death,the average overall survival of patients is 6 months,and the 5-year birth rate is less than 5%,its situation is extremely serious.Due to the hidden symptoms of gallbladder cancer,most patients were already in the advanced stage of gallbladder cancer when receiving treatment,and only about 10% of patients could take surgical treatment.Radical resection plus meticulous lymph node dissection is the best treatment choice.In view of the above situation,it’s particularly important to explore the site pathology of lymph node metastasis of gallbladder carcinoma and the clinicopathological risk factors of lymph node metastasis.ObjectivesTo explore the clinicopathological characteristics and risk factors of lymph node metastasis of gallbladder cancer by studying the clinical data of patients with lymph node metastasis of gallbladder cancer.Methods82 patients with gallbladder cancer who underwent surgical treatment in 988 Hospital of joint logistics support force and Henan Provincial People’s Hospital from January 2016 to January 2020 were selected,including 27 cases of lymph node metastasis(LNM)and 55 cases of non metastasis.There were 13 males and 14 females in the lymph node metastasis group,aged 26-69 years old,with an average age of(47.5±21.5)years old.There were 25 males and 30 females in the lymph node non metastasis group,aged from 25 to 68 years old,with an average of(46.5±21.5)years old.The clinical data of patients were collected and analyzed,mainly including demographic characteristics and clinicopathological characteristics.Demographic characteristics included gender and age.Clinicopathological characteristics included vascular tumor thrombus(LVI),tumor location,liver invasion,histological grade,neural invasion(PNI)and depth of invasion(T stage).To explore the risk factors of lymph node metastasis of gallbladder cancer,the above clinical data were analyzed by logistic univariate and multivariate analysis.Results1.The tumor of the patients with lymph node metastasis of gallbladder cancer mainly concentrated at the bottom of gallbladder,and the tumor morphology was infiltrative,among which the proportion of adenocarcinoma patients was the largest,the pathological grade was mostly low and medium differentiation patients,and the number of TNM stage IIIA patients with lymph node metastasis was more.2.Logistic univariate analysis showed that there was no significant difference in age and gender between patients with lymph node metastasis and patients without lymph node metastasis(P > 0.05);There were significant differences in vessel tumor thrombus,tumor location,liver invasion,histological grade,nerve invasion,T stage between patients with lymph node metastasis and patients without lymph node metastasis(P < 0.05).3.Logistic multivariate analysis showed that vascular tumor thrombus,tumor location,histological grade,nerve invasion and T stage were independent risk factors for lymph node metastasis of gallbladder cancer(P < 0.05).ConclusionsVascular tumor thrombus,tumor location,liver invasion,histological grade,neural invasion and T stage were the risk factors of lymph node metastasis of gallbladder cancer.Vascular tumor thrombus,tumor location,histological grade,neural invasion and T stage were the important risk factors of lymph node metastasis of gallbladder cancer.