Analysis of risk factors of lymph node metastasis in early gastric cancer patients undergo operation / 国际外科学杂志

ABSTRACT

Objective:To investigate the relationship between clinicopathological features and lymph node metastasis(LNM)of early gastric cancer(EGC), so as to provide and theoretical guidance for the normative treatment of EGC.Methods:A retrospective analysis was performed on 128 patients with EGC who received surgical treatment from January 2016 to December 2019 in Anhui Medical University Affiliated Anqing hospital.Results:The total LNM ratio of EGC was 10.1% (13/128). Univariate analysis showed that the LNM ratio was 18.0% in patients with the largest diameter of >2 cm, higher than 5.1% in patients with the largest diameter of ≤2 cm. The LNM ratio of submucosal carcinoma (T 1b) was 21.6%, higher than 2.6% of intramucosal carcinoma (T 1a). The LNM ratio of patients with vascular invasion was 71.4%, higher than 6.7% of patients without vascular invasion. The LNM ratio was 13.1% in the total dissected lymph node group ≥15, higher than 0 in the total dissected lymph node group <15. The difference between the these groups was statistically significant( χ2=5.532, 12.101, 23.778, 4.239, P<0.05). There was no significant difference in the correlation between age, gender, tumor site, general type, degree of differentiation, and the LNM of EGC ( P>0.05). Multivariate analysis showed that submucosal carcinoma(RR=10.688, 95% CI 1.714-66.651, P=0.011) and vascular infiltration(RR=27.209, 95% CI 3.749-197.450, P=0.001) were the independent risk factor for the LNM of EGC. Conclusions:Patients of EGC with tumor infiltration to submucosa(T 1b), maximum diameter of lesion >2 cm, and vascular infiltration have a higher risk of LNM. Standardized D1+ or D2 lymph node dissection (≥15) should be performed for EGC patients.