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目的探索早期胃癌淋巴结转移的影响因素。方法回顾性分析2009年1月至2016年1月期间在笔者所在医院接受手术治疗的187例早期胃癌患者的临床资料,探索年龄、性别、肿瘤位置、肿瘤直径、肿瘤数目、浸润深度、组织学类型、大体形态、脉管浸润及局部溃疡与淋巴结转移的关系。结果本组187例早期胃癌患者中,检测出淋巴结转移32例(17.1%)。多因素logistic回归分析结果显示,早期胃癌患者的淋巴结转移与肿瘤直径(OR=2.080,P=0.022)、浸润深度(OR=21.048,P=0.001)、组织学类型(OR=3.507,P=0.018)、脉管浸润(OR=2.406,P=0.009)及局部溃疡(OR=2.738,P=0.001)均有关,肿瘤直径>2 cm、浸润深度达黏膜下层、组织学类型为未分化型、存在脉管浸润及存在局部溃疡者的淋巴结转移率较高。结论肿瘤直径、浸润深度、组织学类型、脉管浸润和局部溃疡均是淋巴结转移的影响因素。
Objective To explore the influencing factors of lymph node metastasis in early gastric cancer. Methods A retrospective analysis of clinical data of 187 patients with early gastric cancer undergoing surgical treatment at our hospital from January 2009 to January 2016 was conducted to investigate the relationship between age, gender, tumor location, tumor size, tumor size, depth of invasion, histology Type, general morphology, vascular invasion and local ulcer and lymph node metastasis. Results In this group of 187 patients with early gastric cancer, 32 cases (17.1%) of lymph node metastases were detected. Multivariate logistic regression analysis showed that lymph node metastasis and tumor diameter (OR = 2.080, P = 0.022), depth of invasion (OR = 21.048, P = 0.001) and histological type ), Vascular invasion (OR = 2.406, P = 0.009) and local ulceration (OR = 2.738, P = 0.001). The tumor diameter was> 2 cm and the infiltration depth reached the submucosa. The histological type was undifferentiated Vascular invasion and ulceration in those who have a higher rate of lymph node metastasis. Conclusions Tumor diameter, depth of invasion, histological type, vascular invasion and local ulceration are the influencing factors of lymph node metastasis.