Risk factors for lymph node metastasis in patients with early gastric cancer and signet ring cell histology
Risk factors for lymph node metastasis in patients with early gastric cancer and signet ring cell histology
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DOI：
10.1002/bjs.6941
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发表时间：
2010-05-01
影响因子：
9.6
通讯作者：
Ryu, K. W.
中科院分区：
文献类型：
--
作者：
Lee, J. H.;Choi, I. J.;Ryu, K. W.
背景：据报道，具有印戒细胞组织学特征的早期胃癌是一种有利的组织学类型。本研究的目的是确定与此类早期胃癌患者淋巴结转移相关的危险因素。方法：对接受手术的分化型印戒细胞组织学早期胃癌患者进行横断面研究。使用比值比和 95% 置信区间的多元逻辑回归分析来评估危险因素。 结果：在 1362 名因早期胃癌接受胃切除术的患者中，具有印戒细胞和分化组织学表现的肿瘤的淋巴结转移率相似（分别为 10.7% 和 9.0%；P = 0.307）。 Logistic回归分析显示，印戒细胞组织学患者的肿瘤浸润深度可预测淋巴结转移（P < 0.001）。在单变量或多变量分析中，肿瘤大小与淋巴结转移无关。小于2cm的病灶在胃印戒细胞肿瘤和淋巴结转移的患者中并不少见（48例中有6例；13%）。 结论：组织学为印环细胞型的早期胃癌患者很可能接受胃切除加淋巴结清扫术治疗。
Background: Early gastric cancer with signet ring cell histology has been reported as a favourable histological type. The aim of this study was to identify risk factors associated with lymph node metastasis in patients with this type of early gastric cancer.Methods: A cross-sectional study of patients with early gastric cancer with differentiated and signet ring cell histology undergoing surgery was conducted. Risk factors were evaluated using multiple logistic regression analysis with odds ratios and 95 per cent confidence intervals.Results: In 1362 patients undergoing gastrectomy for early gastric cancer, the rate of lymph node metastasis was similar for tumours with signet ring cell and differentiated histological findings (10.7 versus 9.0 per cent respectively; P = 0.307). Logistic regression analysis showed that depth of tumour invasion was predictive of lymph node metastasis in patients with signet ring cell histology (P < 0.001). Tumour size was not associated with lymph node metastasis in either univariable or multivanable analysis. Lesions smaller than 2 cm were not uncommon in patients with signet ring cell gastric tumours and lymph node metastases (six of 48; 13 per cent).Conclusion: Patients with early gastric cancer with signet ring cell-type histology are probably hest treated by gastrectomy with lymph node dissection.