分化不良型早期胃癌淋巴结转移的多因素分析

ObjectiveThepresentstudyanalyzesthelawoflymphaticmetastasisinpatientswithpoorlydifferentiatedearlygastric？？cancerandprovidesabasisforminimallyinvasivetreatmentandnarrowoperativerange.MethodsTheclinicaldataof301patients？？sufferingfrompoorlydifferentiatedearlygastriccancerwereretrospectivelyanalyzed.Thesepatientswereadmittedtoandtreatedinthe？？ChinesePLAGeneralHospitalfromSeptember1983toJune2010.Lymphnodeswerefoundin294patientsafterradicalresection.？Univariate，multivariate，andchromatographicanalysesweredonetoanalyzetheeffectofthefollowingnineclinicopathologicalvariables:？age，gender，tumorsize，location，macroscopictype，depthofinvasion，lymphaticvesselinvolvement，smoking，andtumorfamily？？history.ResultsTheincidencerateoflymphaticmetastasisinpoorlydifferentiatedearlygastriccancerwas19.0%（56/294），fromwhich？？theincidenceratesoflymphaticmetastasisformucosal（M）andsubmucosal（SM）cancerwere4.4%（6/136）and31.6%（50/158）.The？？logisticregressionanalysisshowedthattumorsizesof>1.5cm（P=0.049，OR=2.437），submucosalinvasion（P=0.000，OR=？6.681），lymphaticvesselinvolvement（P=0.000，OR=8.469）areindependentriskfactorsforlymphaticmetastasis.Moreover，the？？chromatographicanalysisshowedthatMlymphaticmetastasiswasinfluencedbytumorsize（P=0.028）andlymphaticvesselinvolvement？（P=0.005），whereasSMlymphaticmetastasiswasinfluencedbylymphaticvesselinvolvement（P=0.000）.ConclusionPoorly？？differentiatedMcancerswithoutlymphaticmetastasiswithtumorsizesof≤1.5cmcanbecuredviaendoscopicmicroinvasivetreatment，？whereasforthosewithtumorsizesof>1.5cm，theoperativerangemaybereduced.？