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目的探讨未分化型早期胃癌(EGC)的淋巴结转移规律。方法对1994年1月至2008年12月手术治疗的335例早期胃癌的临床病理学资料进行回顾性分析。结果未分化型早期胃癌的淋巴结转移率为17.9%,其中黏膜内癌(M癌)和黏膜下层癌(SM癌)的淋巴结转移率分别为10.5%、25.6%,直径≤2.0cm和>2.0cm的淋巴结转移率分别为8.0%和25.8%,脉管瘤栓阳性和脉管瘤栓阴性的淋巴结转移率为50.0%和16.3%。单因素分析显示,肿瘤大小、浸润深度、脉管瘤栓与未分化型早期胃癌淋巴结转移相关(P<0.05)。多因素分析显示,肿瘤最大径>2cm、黏膜下层浸润和脉管瘤栓是未分化型早期胃癌淋巴结转移的独立危险因素(P<0.05)。结论肿瘤直径≤2cm、黏膜内癌、无脉管瘤栓的未分化型早期胃癌发生淋巴结转移风险小。
Objective To investigate the regularity of lymph node metastasis in undifferentiated early gastric cancer (EGC). Methods The clinicopathological data of 335 cases of early gastric cancer surgically treated from January 1994 to December 2008 were retrospectively analyzed. Results The rate of lymph node metastasis in early undifferentiated early gastric cancer was 17.9%. The rates of lymph node metastasis in intramucosal (M) and submucosal (SM) cancers were 10.5%, 25.6%, and those with diameters ≤2.0 cm and> 2.0 cm The rates of lymph node metastasis were 8.0% and 25.8% respectively. The rates of lymph node metastases of positive tumor and negative of tumor thrombus were 50.0% and 16.3%. Univariate analysis showed that tumor size, depth of invasion, angiocarcinoma and lymph node metastasis in undifferentiated early gastric cancer (P <0.05). Multivariate analysis showed that the maximum diameter of tumor> 2cm, submucosal invasion and tumor thrombus were independent risk factors for lymph node metastasis in early undifferentiated gastric cancer (P <0.05). Conclusions There is a low risk of lymph node metastasis in undifferentiated early gastric cancer with tumor diameter ≤2cm, intramucosal carcinoma and without vascular tumor thrombus.