Clinicopathological factors for lymph node metastasis in early gastric cancer / 中华消化内镜杂志

ABSTRACT

Objective:To explore the correlationship of clinicopathological factors and lymph node metastasis (LNM) in early gastric cancer (EGC).Methods:Data of 164 patients diagnosed as EGC by endoscopic biopsy who underwent D2 radical gastrectomy at the First Affiliated Hospital of Army Military Medical University from January 2012 to December 2018 were retrospectively studied. The correlation between the clinicopathological factors and the presence of LNM was analyzed with univariate analysis and multivariate logistic regression.Results:Of the 164 patients, 34 cases had LNM. Univariate analysis showed that tumor size, depth of invasion, histopathologic type and vessel involvement were markedly associated with a higher rate of LNM (all P<0.05). Logistic regression multivariate analysis showed that tumor maximal diameter >2 cm ( OR=3.2, 95% CI: 2.305-4.187), invasion of submucosa ( OR=2.5, 95% CI: 2.091-3.859), poor histological differentiation ( OR=1.7, 95% CI: 1.029-2.933), and vessel involvement ( OR=2.1, 95% CI: 1.817-3.176) were significantly associated with a higher rate of LNM ( P<0.05). The highest frequency of LNM at upper EGC was 66.7% in Group No.1, and 33.3% in Group No.3. The highest frequency of LNM at middle EGC was 75.0% in Group No.3, and 25.0% in Group No.4, and the highest frequency of LNM at lower EGC was 33.3% in Group No.6, 25.9% in Group No. 3, 25.9% in Group No.4, and 14.8% in Group No.7. No metastasis was seen at the first stop of early cancer within mucosa which was well-differentiated and diameter ≤2 cm. Conclusion:Tumor maximal diameter>2 cm, invasion of submucosa, poor histological differentiation, and vessel involvement are risk factors of LNM in EGC. Distribution of LNM is clearly related to the location of cancer. And LNM in EGC shows a proximal-to-distal metastatic pattern.