The Influencing Factors Of Lymphy Node Metastasis Of Undifferentiated-Type Early Gastric Cancer And The Feasibility Of Endoscopic Treatment

ObjectiveThe undifferentiated-type early gastric cancer consists of signet ring cell carcinoma,poorly differentiated adenocarcinoma and mucous adenocarcinoma.This paper discusses the relative risk factors of the lymph node metastasis of undifferentiated-type early gastric cancer and the feasibility of endoscopic treatment of undifferentiated-type of early gastric cancer.Therefore,this article can provide theoretical support to the endoscopic treatment of undifferentiated early gastric cancer.Methods80 cases of undifferentiated-type early gastric cancer patients selected from Qianfoshan Hospital affiliated to Shandong University during the period from January 1,2007 to September 30,2018 were analyzed retrospectively.The relationship between patient’s age,gender,lesion diameter,vascular infiltration,depth of infiltration,location,general type,presence or absence of ulcer and lymph node metastasis was analyzed.Clinicopathological factors were categorized as follows: lesion diameter(maximum diameter ≤ 2cm or >2 cm),depth of infiltration(mucosal or submucosal),location [upper third(fundus),middle third(body),or lower third(antrum)of the stomach],an endoscopic macroscopic tumor type [protrusion(type I,IIa and hybrid of type I and IIa predominantly),flat(type IIb and hybrid of type IIb predominantly),or depression(type IIc,III and hybrid of type IIc and III predominantly)].SPSS 23 software was used for statistical analysis of the data.Firstly,univariate analysis was performed.The measurement data was analyzed by t test,which were represented by mean add and subtract the standard deviation.While the count data or rate was analyzed by chi-square test.Then the multivariate analysis was done by the multiple logistic analysis.A P value less than 0.05 was considered significa-ntly.ResultsThrough the univariate analysis,the tumor diameter(P=0.002),depth of invasion(P=0.002)and lymphatic-vascular involvement(P=0.000)are associated with lymph node metastasis significantly.While the patient’s age,gender,tumor location,general type,presence or absence of ulcer have no significant correlation to lymph node metastasis.Multivariate analysis was done by the multiple logistic analysis with the the above related indicators,which showed that the tumor with the maximum diameter >2cm(P=0.034,OR=13.976),the invasion to the submucosa(P=0.041,OR=6.726),or the lymphatic-vascular involvement(P=0.010,OR=12.975)are the independent risk factors of lymph node metastasis.ConclusionThe tumor with diameter >2cm(P=0.034,OR=13.976),the invasion to the submucosa(P=0.041,OR=6.726),or the lymphatic-vascular involvement(P=0.010,OR=12.975)are the independent risk factors of lymph node metastasis.For patients with undifferentiated early gastric cancer,whether endoscopic treatment is feasible and whether additional surgery is required after endoscopic treatment,the above three risk factors can be used as the basis for judgement.