Risk factors predictive of lymph node metastasis in depressed early gastric cancer
Risk factors predictive of lymph node metastasis in depressed early gastric cancer
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DOI：
10.1016/s0002-9610(01)00860-1
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发表时间：
2002-02-01
影响因子：
3
通讯作者：
Atomi, Y
中科院分区：
文献类型：
--
作者：
Abe, N;Watanabe, T;Atomi, Y
背景资料：本研究的目的是确定抑郁症早期胃癌区域淋巴结转移的危险因素，并进一步建立一个客观标准，用于指导通过内镜粘膜切除术（EMR）发现粘膜下肿瘤明显扩展的病例进行额外的手术治疗。收集了276例经手术治疗的抑郁型早期胃癌患者的资料，分析了患者与肿瘤特征的关系，结果：多因素Logistic回归分析显示，女性、肿瘤直径≥ 20 mm、黏膜下浸润、淋巴管受累是影响淋巴结转移的独立危险因素。在145例粘膜下浸润性癌患者中，在不显示其他三个危险因素的患者中没有观察到淋巴结转移，而在这些因素中的一个和两个的患者中，分别有14.3%和23.3%的患者有淋巴结转移。淋巴结转移率计算为86.7%的患者谁拥有所有三个factor.Conclusions：粘膜下浸润，女性，肿瘤大小为20毫米或以上，淋巴管受累是显着的，独立相关的淋巴结转移在抑郁症早期胃癌的存在。后三个危险因素的阳性数是一个简单的标准，表明在EMR首次发现粘膜下浸润的病例中需要进行额外的手术治疗。(C)2002年，Excerpta Medica，Inc. All rights reserved.
Background: This study was conducted to identify risk factors predictive of regional lymph node metastasis in depressed early gastric cancer and further to establish an objective criterion useful to indicate additional surgical treatment in cases in which submucosal tumor extension becomes evident by endoscopic mucosal resection (EMR).Methods: Data from 276 patients surgically treated for depressed early gastric cancer were collected, and the relationship between the patient and tumor characteristics, and the lymph node metastasis was retrospectively evaluated by multivariate analysis.Results: In the multivariate logistic regression model, female sex, a larger tumor size (20 mm or more), submucosal invasion, and presence of lymphatic vessel involvement were found to be independent risk factors for lymph node metastasis. Among 145 patients with submucosally invasive carcinoma, no lymph node metastasis was observed in patients who showed none of the other three risk factors, whereas 14.3% and 23.3% of patients with one and two of these factors had lymph node metastasis, respectively. The lymph node metastasis rate was calculated to be 86.7% in patients who had all three factors.Conclusions: Submucosal invasion, female sex, tumor size of 20 mm or more, and lymphatic vessel involvement were significantly and independently related to the presence of lymph node metastasis in depressed early gastric cancer. The positive number of the latter three risk factors is a simple criterion to indicate additional surgical treatment in cases with submucosal invasion revealed first by EMR. (C) 2002 Excerpta Medica, Inc. All rights reserved.