The risk of lymph node metastasis in gastric cancer conforming to indications of endoscopic resection and pylorus-preserving gastrectomy: a single-center retrospective study.
The risk of lymph node metastasis in gastric cancer conforming to indications of endoscopic resection and pylorus-preserving gastrectomy: a single-center retrospective study.
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符合内镜切除和保留幽门胃切除指征的胃癌淋巴结转移风险的单中心回顾性研究。
DOI：
10.1186/s12885-021-09008-8
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发表时间：
2021-11-27
期刊：
影响因子：
3.8
通讯作者：
Zhao W
中科院分区：
文献类型：
--
作者：
Yanzhang W;Guanghua L;Zhihao Z;Zhixiong W;Zhao W
淋巴结转移（LNM）状态是影响早期胃癌治疗决策的重要预后因素。本研究旨在探讨EGC中LNM的类型及临床意义。本研究共纳入354例行根治性胃切除术的原位癌（n = 42）、胃癌（n = 312）患者。收集并分析其临床病理特征、病理报告及预后资料。所有患者中LNM的发生率为18.36%（65/354）。D1和D2站转移率分别为12.10%（43/354）和6.21%（22/354）。LNM的绝对指征率为3.27%(2/61)，扩大指征率为28.55%（4/14）。3.67%（13/354）的患者出现跳跃性LNM。中1 / 3肿瘤5号淋巴结转移率为3.05%（5/164）。LNM的独立危险因素为肿瘤大小为bbb30 mm、肿瘤低分化、淋巴血管浸润（P < 0.05，曲线下面积为0.783）。合并和不合并LNM患者的5年无病生存率分别为96.26%和79.17% （P = 0.011）。肿瘤大小为bbb20 mm和LNM是所有患者生存预后差的独立预测因素。符合扩大适应症的EGC患者发生LNM的风险相对较高，可能不适合内镜下粘膜下剥离。由于5号淋巴结的高转移率，保留幽门的胃切除术对中三分之一的胃癌患者仍然存在争议。
Lymph node metastasis (LNM) status is an important prognostic factor that strongly influences the treatment decision of early gastric cancer (EGC). This study aimed to evaluate the pattern and clinical significance of LNM in EGC. A total of 354 patients with carcinoma in situ (n = 42), EGC (n = 312) who underwent radical gastrectomy were enrolled. Their clinicopathological features, pathological reports, and prognostic data were collected and analyzed. The incidence of LNM in all patients was 18.36% (65/354). The rates of D1 and D2 station metastases were 12.10% (43/354) and 6.21% (22/354), respectively. The rates of LNM in absolute indication of endoscopic resection and expanded indication were 3.27% (2/61) and 28.55% (4/14), respectively. Skip LNM was observed in 3.67% (13/354) of patients. For those with middle-third tumor, the metastasis rate of the No. 5 lymph node was 3.05% (5/164). The independent risk factors for LNM were tumors measuring > 30 mm, poorly differentiated tumors, and lymphovascular invasion (all P < 0.05; area under the curve, 0.783). The 5-year disease-free survival rates of patients with and without LNM were 96.26 and 79.17%, respectively (P = 0.011). Tumors measuring > 20 mm and LNM were independent predictive factors for poor survival outcome in all patients. Patients with EGC conforming to expanded indications have a relatively high risk of LNM and may not be suitable for endoscopic submucosal dissection. Pylorus-preserving gastrectomy for patients with middle-third EGC remains controversial due to the high metastasis rate of the No. 5 lymph node.
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DOI：
10.1007/pl00011720
发表时间：
2000-12-01
期刊：
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
影响因子：
--
作者：
Gotoda, Takuji;Yanagisawa, Akio;Kato, Yo
通讯作者：
Kato, Yo
影响因子：
3.6
作者：
Liu, Jin-Yuan;Deng, Jing-Yu;Liang, Han
通讯作者：
Liang, Han
影响因子：
7.4
作者：
Hirasawa, Toshiaki;Gotoda, Takuji;Yamaguchi, Toshiharu
通讯作者：
Yamaguchi, Toshiharu
影响因子：
4.3
作者：
Eom, Bang Wool;Park, Boram;Kim, Young-Woo
通讯作者：
Kim, Young-Woo
影响因子：
7.7
作者：
Choi AH;Nelson RA;Merchant SJ;Kim JY;Chao J;Kim J
通讯作者：
Kim J