中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2010年
4期
297-300
,共4页
王婕敏%周丽雅%林三仁%丁士刚
王婕敏%週麗雅%林三仁%丁士剛
왕첩민%주려아%림삼인%정사강
危险因素%早期胃癌%淋巴结转移%治疗方式
危險因素%早期胃癌%淋巴結轉移%治療方式
위험인소%조기위암%림파결전이%치료방식
Risk factors%Early gastric cancer%Lymph node metastasis%Therapeutic options
目的 探讨早期胃癌淋巴结转移规律及其影响因素,为选择合适的治疗方法提供依据.方法 对北京大学第三医院1988年3月-2009年3月于外科行胃癌根治术治疗的103例早期胃癌患者临床资料进行回顾性研究,对患者的年龄、性别,肿瘤的大小、部位、大体类型、分化程度及浸润深度与淋巴结转移的关系进行单因素及多因素分析.结果 早期胃癌的淋巴结转移率为17.5%(18/103),其中黏膜内癌的淋巴结转移率为4.1%(2/49),黏膜下层癌的淋巴结转移率为29.6%(16/54).logistic回归分析显示,浸润至黏膜下层(P=0.001)及肿瘤>2 cm(P=0.003)为早期胃癌淋巴结转移的独立危险因子.黏膜内癌发生淋巴结转移的2例均为直径>2 cm的印戒细胞癌;黏膜下层癌中,≤2 cm肿瘤的淋巴结转移率为16.1%(5/31),>2 cm肿瘤的淋巴结转移率高达47.8%(11/23)(P=0.012).高分化程度的早期胃癌的淋巴结转移率为0(0/13),中分化癌转移率为18.2%(4/22),低分化癌转移率为16.7%(5/30),印戒细胞癌转移率为23.7%(9/38),各组间差异无统计学意义(P=0.294).患者的年龄、性别、肿瘤部位(胃上部、中部、下部)和大体分型(隆起型、平坦型和凹陷型)与淋巴结转移无相关性.结论 肿瘤大小和浸润深度与早期胃癌淋巴结转移相关,决定早期胃癌治疗方案时,可参考上述因素判断淋巴结转移风险.
目的 探討早期胃癌淋巴結轉移規律及其影響因素,為選擇閤適的治療方法提供依據.方法 對北京大學第三醫院1988年3月-2009年3月于外科行胃癌根治術治療的103例早期胃癌患者臨床資料進行迴顧性研究,對患者的年齡、性彆,腫瘤的大小、部位、大體類型、分化程度及浸潤深度與淋巴結轉移的關繫進行單因素及多因素分析.結果 早期胃癌的淋巴結轉移率為17.5%(18/103),其中黏膜內癌的淋巴結轉移率為4.1%(2/49),黏膜下層癌的淋巴結轉移率為29.6%(16/54).logistic迴歸分析顯示,浸潤至黏膜下層(P=0.001)及腫瘤>2 cm(P=0.003)為早期胃癌淋巴結轉移的獨立危險因子.黏膜內癌髮生淋巴結轉移的2例均為直徑>2 cm的印戒細胞癌;黏膜下層癌中,≤2 cm腫瘤的淋巴結轉移率為16.1%(5/31),>2 cm腫瘤的淋巴結轉移率高達47.8%(11/23)(P=0.012).高分化程度的早期胃癌的淋巴結轉移率為0(0/13),中分化癌轉移率為18.2%(4/22),低分化癌轉移率為16.7%(5/30),印戒細胞癌轉移率為23.7%(9/38),各組間差異無統計學意義(P=0.294).患者的年齡、性彆、腫瘤部位(胃上部、中部、下部)和大體分型(隆起型、平坦型和凹陷型)與淋巴結轉移無相關性.結論 腫瘤大小和浸潤深度與早期胃癌淋巴結轉移相關,決定早期胃癌治療方案時,可參攷上述因素判斷淋巴結轉移風險.
목적 탐토조기위암림파결전이규률급기영향인소,위선택합괄적치료방법제공의거.방법 대북경대학제삼의원1988년3월-2009년3월우외과행위암근치술치료적103례조기위암환자림상자료진행회고성연구,대환자적년령、성별,종류적대소、부위、대체류형、분화정도급침윤심도여림파결전이적관계진행단인소급다인소분석.결과 조기위암적림파결전이솔위17.5%(18/103),기중점막내암적림파결전이솔위4.1%(2/49),점막하층암적림파결전이솔위29.6%(16/54).logistic회귀분석현시,침윤지점막하층(P=0.001)급종류>2 cm(P=0.003)위조기위암림파결전이적독립위험인자.점막내암발생림파결전이적2례균위직경>2 cm적인계세포암;점막하층암중,≤2 cm종류적림파결전이솔위16.1%(5/31),>2 cm종류적림파결전이솔고체47.8%(11/23)(P=0.012).고분화정도적조기위암적림파결전이솔위0(0/13),중분화암전이솔위18.2%(4/22),저분화암전이솔위16.7%(5/30),인계세포암전이솔위23.7%(9/38),각조간차이무통계학의의(P=0.294).환자적년령、성별、종류부위(위상부、중부、하부)화대체분형(륭기형、평탄형화요함형)여림파결전이무상관성.결론 종류대소화침윤심도여조기위암림파결전이상관,결정조기위암치료방안시,가삼고상술인소판단림파결전이풍험.
Objective To summarize the characteristics of regional lymph node metastasis in patients with early gastric cancer and analyze the risk factors for lymphatic metastasis. Methods 103 cases surgically treated for early gastric cancer in the Third Hospital of Peking University between March, 1988 and March, 2009 were analyzed retrospectively. Several clinicalpathologic variables including patients' age, gender, size of tumor, tumor location, macroscopic type, histological type, invasion depth were investigated by using chi-square test and logistic regression analysis for the possible relationship to lymphatic metastasis. Results The rate of lymph node metastasis in early gastric cancer was 17.5% (18/103), which in mucosal cancer was 4. 1% (2/49). Submucosal cancer had a lymph node metastatic rate of 29. 6% (16/54). Logistic regression indicated that invasion to submucosa and tumor size > 2 em were independent risk factors for lymph node metastasis of early gastric cancer. Metastatic cases of mucosal cancer were all signet ring cell cancer with diameters more than 2 cm. Lymph node metastatic rate in submueosal cancers within 2 cm was 16. 1% (5/31), that in > 2 cm submucosal cancers was 47. 8% (11/23) (P = 0. 012). Rate of lymph node metastasis in well-differentiated cancers was 0 (0/13), that in moderately-differentiated, poorly differentiated and signet ring cell cancers were 18. 2% (4/22), 16. 7% (5/30) and 23.7% (9/38) respectively (P = 0. 294). Patients' age, gender, tumor location and macroscopic type showed no relationship with lymph node state. Conclusion The tumor size and invasion depth are related with lymph node metastasis in early gastric cancer, considering these factors and assessing lymph node state is essential to appropriate therapeutic options for early gastric cancer.
