Risk factors of lymphatic metastasis in early gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YU Lei , ZHAO Yajun ,  NING Zhongliang

Department of Gastrointestinal Tumor Surgery, Anhui Tumor Hospital, Hefei 230001, P. R. China;

Corresponding?author：

NING Zhongliang, Email: 806819678@qq.com

Keywords：

early gastric cancer; lymphatic metastasis; risk factor; therapeutic option

DOI：

10.7507/1007-9424.201803050

Video：

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Objective To analyze risk factors of lymphatic metastasis in early gastric cancer in order to discuss reasonable therapeutic regimen. Methods The clinical data of 148 patients with early gastric cancer surgically treated in the Anhui Tumor Hospital from February 2013 to November 2017 were retrospectively analyzed. The relationship between the lymphatic metastasis with the clinicopathologic characteristics of the patient with the early gastric cancer was analyzed by the univariate and multiple regression analyses. Results The lymphatic metastasis were observed in 15 of 148 patients (10.14%), 1 in the 70 (1.43%) mucosal lesions and 14 in the 78 (17.95%) submucosal lesions. The results of the univariate analysis showed that the patients’ age, size of tumor, macroscopic type, invasion depth, and vascular invasion were related to the lymphatic metastasis in the early gastric cancer (P<0.050), the results of the multiple regression analysis showed that the invasion depth and vascular invasion were the independent risk factors of the lymphatic metastasis in the early gastric cancer (P<0.050). Conclusions Invasion depth and vascular invasion are closely related to lymphatic metastasis in early gastric cancer. Precise evaluation of lymphatic metastasis before treatment is very important to patient with early gastric cancer.

Citation： YU Lei, ZHAO Yajun, NING Zhongliang. Risk factors of lymphatic metastasis in early gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(10): 1190-1193. doi: 10.7507/1007-9424.201803050 Copy

1.	Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma—2nd English Edition. Gastric Cancer, 1998, 1(1): 10-24.
2.	Soetikno R, Kaltenbach T, Yeh R, et al. Endoscopic mucosal resection for early cancers of the upper gastrointestinal tract. J Clin Oncol, 2005, 23(20): 4490-4498.
3.	Tan D, Lauwers GY. Advances in surgical pathology//Gastric cancer. Philadelphia: Lippincott Williams & Wilkins, 2011: 73.
4.	Ono H. Early gastric cancer: diagnosis, pathology, treatment techniques and treatment outcomes. Eur J Gastroenterol Hepatol, 2006, 18(8): 863-866.
5.	王浩, 周巖冰, 牛兆建, 等. 早期胃癌預后及復發轉移因素分析. 中華普通外科雜志, 2015, 30(8): 639-642.
6.	王永向, 高亮, 王元宇, 等. 早期胃癌預后的影響因素分析. 中華胃腸外科雜志, 2014, 17(2): 180-181.
7.	Saka M, Katai H, Fukagawa T, et al. Recurrence in early gastric cancer with lymph node metastasis. Gastric Cancer, 2008, 11(4): 214-218.
8.	Kwee RM, Kwee TC. Predicting lymph node status in early gastric cancer. Gastric Cancer, 2008, 11(3): 134-148.
9.	Shen ZL, Song KY, Ye YJ, et al. Significant differences in the clinicopathological characteristics and survival of gastric cancer patients from two cancer centers in china and Korea. J Gastric Cancer, 2015, 15(1): 19-28.
10.	劉國棟, 李曉波, 李昌榮, 等. 早期胃癌淋巴結轉移的研究進展. 中華消化外科雜志, 2016, 15(1): 93-96.
11.	程巍, 高順良. 老年胃癌的診療進展. 浙江創傷外科, 2016, 21(4): 809-812.
12.	荊曉岳, 王建國, 周兵, 等. 10年豫北地區胃癌臨床流行病學特征. 中國普外基礎與臨床雜志, 2010, 17(1): 29-33.
13.	王力, 梁寒, 王曉娜, 等. 早期胃癌淋巴結轉移規律及影響因素. 中華胃腸外科雜志, 2013, 16(2): 147-150.
14.	鄒振玉, 沈笛, 杜曉輝, 等. 早期胃癌淋巴結轉移相關因素和淋巴結清掃范圍的探討. 中華普通外科雜志, 2016, 31(6): 456-459.
15.	徐靜, 項鋒鋼, 王寧. 胃癌微淋巴管的增殖狀態及分布特點. 青島大學醫學院學報, 2007, 43(6): 473-476.
16.	戴冬秋, 張春東. 早期胃癌的外科治療策略. 醫學與哲學, 2016, 37(4): 8-11.
17.	劉嵐, 王云霞, 郭建強. 內鏡黏膜下剝離術和內鏡下黏膜切除術治療早期胃癌的Meta分析. 中國老年學雜志, 2015, 35(7): 1804-1808.
18.	彭志華. 早期胃癌行內鏡黏膜下剝離術的有效性與可行性分析. 現代中西醫結合雜志, 2015, 27(24): 2986-2988.
19.	李忠武. 早期胃癌規范化診治流程及預后因素. 臨床與病理雜志, 2015, 35(6): 928-932.
20.	Lian J, Chen S, Zhang Y, et al. A meta-analysis of endoscopic submucosal dissection and EMR for early gastric cancer. Gastrointest Endosc, 2012, 76(4): 763-770.
21.	所劍, 王大廣, 劉澤鋒. 早期胃癌診斷和治療. 中國實用外科雜志, 2011, 31(8): 717-719.
22.	謝洪虎, 呂成余, 陳維, 等. 958例胃癌臨床病理資料分析. 中國普外基礎與臨床雜志, 2011, 18(2): 153-158.
23.	Fujii M, Egashira Y, Akutagawa H, et al. Pathological factors related to lymph node metastasis of submucosally invasive gastric cancer: criteria for additional gastrectomy after endoscopic resection. Gastric Cancer, 2013, 16(4): 521-530.
24.	An JY, Baik YH, Choi MG, et al. Predictive factors for lymph node metastasis in early gastric cancer with submucosal invasion: analysis of a single institutional experience. Ann Surg, 2007, 246(5): 749-753.
25.	范曉飛, 戈之錚, 高云杰, 等. 早期胃癌淋巴結轉移規律及內鏡切除指征的探討. 中華消化內鏡雜志, 2013, 30(11): 626-630.
26.	婁喬, 練晶晶, 曾曉清, 等. 早期胃癌473例淋巴結轉移與臨床病理特征相關性分析. 中華消化雜志, 2015, 35(1): 19-21.
27.	蔣楠, 鄧靖宇, 劉勇, 等. 淋巴結轉移陰性的低分化和未分化胃腺癌的預后因素分析. 中華消化外科雜志, 2014, 13(8): 629-632.
28.	Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010(ver. 3). Gastric Cancer, 2011, 14(2): 113-123.

1. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma—2nd English Edition. Gastric Cancer, 1998, 1(1): 10-24.
2. Soetikno R, Kaltenbach T, Yeh R, et al. Endoscopic mucosal resection for early cancers of the upper gastrointestinal tract. J Clin Oncol, 2005, 23(20): 4490-4498.
3. Tan D, Lauwers GY. Advances in surgical pathology//Gastric cancer. Philadelphia: Lippincott Williams & Wilkins, 2011: 73.
4. Ono H. Early gastric cancer: diagnosis, pathology, treatment techniques and treatment outcomes. Eur J Gastroenterol Hepatol, 2006, 18(8): 863-866.
5. 王浩, 周巖冰, 牛兆建, 等. 早期胃癌預后及復發轉移因素分析. 中華普通外科雜志, 2015, 30(8): 639-642.
6. 王永向, 高亮, 王元宇, 等. 早期胃癌預后的影響因素分析. 中華胃腸外科雜志, 2014, 17(2): 180-181.
7. Saka M, Katai H, Fukagawa T, et al. Recurrence in early gastric cancer with lymph node metastasis. Gastric Cancer, 2008, 11(4): 214-218.
8. Kwee RM, Kwee TC. Predicting lymph node status in early gastric cancer. Gastric Cancer, 2008, 11(3): 134-148.
9. Shen ZL, Song KY, Ye YJ, et al. Significant differences in the clinicopathological characteristics and survival of gastric cancer patients from two cancer centers in china and Korea. J Gastric Cancer, 2015, 15(1): 19-28.
10. 劉國棟, 李曉波, 李昌榮, 等. 早期胃癌淋巴結轉移的研究進展. 中華消化外科雜志, 2016, 15(1): 93-96.
11. 程巍, 高順良. 老年胃癌的診療進展. 浙江創傷外科, 2016, 21(4): 809-812.
12. 荊曉岳, 王建國, 周兵, 等. 10年豫北地區胃癌臨床流行病學特征. 中國普外基礎與臨床雜志, 2010, 17(1): 29-33.
13. 王力, 梁寒, 王曉娜, 等. 早期胃癌淋巴結轉移規律及影響因素. 中華胃腸外科雜志, 2013, 16(2): 147-150.
14. 鄒振玉, 沈笛, 杜曉輝, 等. 早期胃癌淋巴結轉移相關因素和淋巴結清掃范圍的探討. 中華普通外科雜志, 2016, 31(6): 456-459.
15. 徐靜, 項鋒鋼, 王寧. 胃癌微淋巴管的增殖狀態及分布特點. 青島大學醫學院學報, 2007, 43(6): 473-476.
16. 戴冬秋, 張春東. 早期胃癌的外科治療策略. 醫學與哲學, 2016, 37(4): 8-11.
17. 劉嵐, 王云霞, 郭建強. 內鏡黏膜下剝離術和內鏡下黏膜切除術治療早期胃癌的Meta分析. 中國老年學雜志, 2015, 35(7): 1804-1808.
18. 彭志華. 早期胃癌行內鏡黏膜下剝離術的有效性與可行性分析. 現代中西醫結合雜志, 2015, 27(24): 2986-2988.
19. 李忠武. 早期胃癌規范化診治流程及預后因素. 臨床與病理雜志, 2015, 35(6): 928-932.
20. Lian J, Chen S, Zhang Y, et al. A meta-analysis of endoscopic submucosal dissection and EMR for early gastric cancer. Gastrointest Endosc, 2012, 76(4): 763-770.
21. 所劍, 王大廣, 劉澤鋒. 早期胃癌診斷和治療. 中國實用外科雜志, 2011, 31(8): 717-719.
22. 謝洪虎, 呂成余, 陳維, 等. 958例胃癌臨床病理資料分析. 中國普外基礎與臨床雜志, 2011, 18(2): 153-158.
23. Fujii M, Egashira Y, Akutagawa H, et al. Pathological factors related to lymph node metastasis of submucosally invasive gastric cancer: criteria for additional gastrectomy after endoscopic resection. Gastric Cancer, 2013, 16(4): 521-530.
24. An JY, Baik YH, Choi MG, et al. Predictive factors for lymph node metastasis in early gastric cancer with submucosal invasion: analysis of a single institutional experience. Ann Surg, 2007, 246(5): 749-753.
25. 范曉飛, 戈之錚, 高云杰, 等. 早期胃癌淋巴結轉移規律及內鏡切除指征的探討. 中華消化內鏡雜志, 2013, 30(11): 626-630.
26. 婁喬, 練晶晶, 曾曉清, 等. 早期胃癌473例淋巴結轉移與臨床病理特征相關性分析. 中華消化雜志, 2015, 35(1): 19-21.
27. 蔣楠, 鄧靖宇, 劉勇, 等. 淋巴結轉移陰性的低分化和未分化胃腺癌的預后因素分析. 中華消化外科雜志, 2014, 13(8): 629-632.
28. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010(ver. 3). Gastric Cancer, 2011, 14(2): 113-123.

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Risk factors of lymphatic metastasis in early gastric cancer

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