60岁以上早期胃癌患者发生胃周淋巴结转移的危险因素

doi:10.3969/j.issn.1671-7171.2023.02.026

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摘要【目的】探讨60岁以上早期胃癌患者发生胃周围淋巴结转移的危险因素。【方法】回顾性分析2011年1月至2021年1月于本院行胃癌根治D₂淋巴结清扫术治疗的256例60岁以上早期胃癌患者的临床资料,根据病理组织检查结果将患者分为未转移组和淋巴转移组,分析60岁以上早期胃癌患者发生胃周淋巴结发生转移的相关危险因素。【结果】256例60岁以上早期胃癌患者均成功行胃癌根治D₂淋巴结清扫术治疗,共有35例(13.7%)发生胃周淋巴结转移。单因素分析显示,淋巴转移组肿瘤浸润深度至黏膜下层、肿瘤直径≥20 mm、低分化及血管侵犯所占比例显著高于未转移组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,血管侵犯、低分化是早期胃癌患者术后发生胃周淋巴结转移的独立危险因素(P<0.05)。【结论】血管侵犯、低分化是60岁以上早期胃癌患者发生胃周淋巴结发生转移的独立风险因素,对存在高危风险的早期胃癌患者需考虑行根治性手术切除。

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关键词 ：胃肿瘤, 肿瘤分期, 淋巴转移, 危险因素

Abstract：【Objective】To investigate the risk factors of perigastric lymph node metastasis in patients over 60 years old with early gastric cancer. 【Methods】 The clinical data of 256 patients with early gastric cancer over 60 years old who underwent radical D₂ lymphadenectomy for gastric cancer in our hospital from January 2011 to January 2021 were retrospectively analyzed. According to the results of pathological examination,the patients were divided into non-metastatic group and lymph node metastasis group,and the related risk factors of perigastric lymph node metastasis in patients with early gastric cancer over 60 years old were analyzed. 【Results】 A total of 256 cases of early gastric cancer over 60 years old were successfully treated with D₂ lymphadenectomy,and 35 cases (13.7%) had perigastric lymph node metastasis. Univariate analysis showed that the proportion of tumor invasion depth to submucosa,tumor diameter ≥ 20 mm,low differentiation and vascular invasion in the lymph metastasis group was significantly higher than that in the non-metastasis group (P<0.05). Multivariate logistic regression analysis showed that vascular invasion and poor differentiation were independent risk factors for perigastric lymph node metastasis in patients with early gastric cancer after operation (P<0.05). 【Conclusion】 Vascular invasion and low differentiation are independent risk factors for perigastric lymph node metastasis in early gastric cancer patients over 60 years old. For early gastric cancer patients with high risk,radical resection should be considered.

Key words： Stomach Neoplasms Neoplasm Staging Lymphatic Metastasis Risk Factors

收稿日期: 2021-09-03

中图分类号:

R735.2

通讯作者: *E-mail:shijiema99@126.com

引用本文:

罗小玲, 王绍闯, 李苗苗, 沈鹏, 马士杰. 60岁以上早期胃癌患者发生胃周淋巴结转移的危险因素[J]. 医学临床研究, 2023, 40(2): 252-254.
LUO Xiao-ling, WANG Shao-chuang, LI Miao-miao,et al. Risk Factors of Perigastric Lymph Node Metastasis in Patients over 60 Years Old with Early Gastric Cancer. JOURNAL OF CLINICAL RESEARCH, 2023, 40(2): 252-254.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.02.026 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I2/252

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