Lymph node metastasis and prognostic analysis of early gastric cancer patients

Y. Wu, M. Xie, Yunlong Cai, Tao Wu, Shan-jun Huang, Xin Wang
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Abstract

Objective To investigate the correlation between clinicopathological features and lymph node metastasis in early gastric cancer(EGC) and evaluate the influence of lymph node metastasis on the overall survival. Methods The clinicopathological data of 178 EGC patients undergoing radical gastrectomy with lymphadenectomy in Peking University First Hospital between Jan 2006 and Dec 2015 were retrospectively reviewed. The impact of lymph node metastasis on the overall survival was analyzed. Results Lymph node metastasis was detected in 19 (10.7%) of 178 patients. Univariate analysis showed a positive relationship between tumor size (χ2=4.804, P=0.028), depth of invasion(χ2=8.176, P=0.003), histological type (χ2=4.333, P=0.037), vascular tumor thrombus (χ2=9.992, P=0.002) and lymph node metastasis in EGC. Multivariate analysis revealed that depth of invasion(Wald=4.954, P=0.026) and intra-vascular tumor thrombus (Wald=3.966, P=0.046)were independent relative factors of lymph node metastasis in EGC patients. The 5-year survival rates of EGC patients with lymph node metastasis were 78.9%, much lower than that without lymph node metastasis (94.3%, χ2=8.310, P=0.004). Conclusions Lymph node metastasis in EGC is mainly correlated with depth of invasion and intra-vascular tumor thrombus. The prognosis of patients with lymph node metastasis is significantly poorer than those without lymph node metastasis. Key words: Stomach neoplasms; Lymphatic metastasis; Prognosis
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癌症早期患者淋巴结转移及预后分析
目的探讨癌症早期淋巴结转移与临床病理特征的相关性,探讨淋巴结转移对患者生存的影响。方法回顾性分析2006年1月至2015年12月在北京大学第一医院行根治性胃切除术并淋巴结清扫的178例EGC患者的临床病理资料。分析淋巴结转移对总生存率的影响。结果178例患者中有19例(10.7%)淋巴结转移。单因素分析显示,EGC中肿瘤大小(χ2=4.804,P=0.028)、浸润深度(χ2=8.176,P=0.003)、组织学类型(χ2=4.333,P=0.037)、血管瘤栓(χ2=9.992,P=0.002)与淋巴结转移呈正相关。多因素分析显示,浸润深度(Wald=4.954,P=0.026)和血管内瘤栓(Wald=3.966,P=0.046)是EGC患者淋巴结转移的独立相关因素。有淋巴结转移的EGC患者5年生存率为78.9%,远低于无淋巴结转移者(94.3%,χ2=8.310,P=0.004)。有淋巴结转移的患者预后明显低于无淋巴结转移患者。关键词:胃肿瘤;淋巴结转移;预后
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