内镜下治疗未分化型早期胃癌的临床研究.pdfVIP

中国肿瘤临床2015年第42卷第19期 ChinJClinOncol2015.Vol.42.No.19 969 临床研究与应用 · · 内镜下治疗未分化型早期胃癌的临床研究 李华 霍志斌 吴殿超 翟同善 肖琦海 王淑霞 张丽丽 摘要 目的：探讨未分化型早期胃癌淋巴结转移的危险因素，从而对未分化型早期胃癌患者行内镜下治疗提供理论依据。 方法：回顾性分析河北医科大学附属邢台市人民医院肿瘤外科1996年1月至2008年12月90例未分化型早期胃癌的临床病理资 料，按照临床病理特征与淋巴结转移的关系进行统计学分析。结果：通过多因素分析，肿瘤大小2cm，淋巴管癌栓和黏膜下癌对 淋巴结转移的差异具有统计学意义（P0.05）。无危险因素的患者，淋巴结转移率为0；3个危险因素均有者，淋巴结转移率高达 57.1%。结论：肿瘤大小2cm，存在淋巴管癌栓和黏膜下癌是未分化型早期胃癌淋巴结转移的独立危险因素。对于无危险因素 的患者，行内镜下切除是可行的。 关键词 早期胃癌 淋巴结转移 临床病理特征 内镜下黏膜切除术 内镜黏膜下剥离术 doi:10.3969/j.issn.1000-8179.2015.19.767 Endoscopic therapy in undifferentiated early gastric cancer Hua LI, Zhibin HUO, Dianchao WU, Tongshan ZHAI, Qihai XIAO, Shuxia WANG, Lili ZHANG Correspondence to: Hua LI; E-mail: lihua200626478@126.com The Second Department of Surgical Oncology, Xingtai Peoples Hospital Affiliated to Hebei Medical University, Xingtai 054001, China. Abstract Objective: To investigate the clinicopathological factors predictive of lymph node metastasis (LNM) in undifferentiat- ed early gastric cancer (EGC) and to expand the possibility of endoscopic therapy for treating undifferentiated EGC.Methods: The re- searchers collected the data of 90 undifferentiated EGC patients who had undergone surgery at the Xingtai Peoples Hospital, Xingtai, China. The relationship between LNM and clinicopathological factors was retrospectively analyzed using univariate and multivariate lo- gistic regression analyses. Results: Univariate analysis showed that tumor size, lymphatic vessel involvement (LVI), and cancer inva- sion depth were the significant and independent risk factors for LNM. The LNM rate was 57.1% in patients with the three clinicopatho- logical risk factors. LNM was not found in patients wi