Differences of Lymph Node Metastasis Between Early Proximal and Distal Gastric Cancer and Indication of Endoscopic Resection / 胃肠病学

ABSTRACT

Background:In recent years,a rising incidence of proximal gastric cancer(PGC)has been reported,in contrast to a declining trend of distal gastric cancer(DGC). Differences in clinicopathological features between PGC and DGC have also been reported. Aims:To investigate the differences of lymph node metastasis between early PGC and DGC and the indication of endoscopic resection. Methods:The clinical data of 420 early gastric cancer patients(101 PGC patients and 319 DGC patients)who underwent curative gastrectomy from June 2013 to June 2016 at the Affiliated Drum Tower Hospital of Nanjing University Medical School were retrospectively analyzed. Clinicopathological features were compared between early PGC and DGC,and risk factors of lymph node metastasis were analyzed. Results:The differences in gender,age, histological differentiation,ulceration and lymph node metastasis were significant between early PDG and DGC patients (P<0.05). Tumor site,tumor size,depth of invasion,histological differentiation and vascular invasion were significantly correlated with lymph node metastasis by univariate analysis(P<0.05). Multivariate analysis revealed that tumor site, depth of invasion,histological differentiation and vascular invasion were independent risk factors for lymph node metastasis (P<0.05). The lymph node metastasis rate of mucosal,differentiated and vascular invasion negative PGC was 2.8%, which was lower than that of DGC(8.3%). Conclusions:The clinicopathological features of early PGC are different from those of early DGC. Patients with mucosal,differentiated and vascular invasion negative PGC are more suitable for endoscopic resection.