首页|pT1b期分化型早期胃癌淋巴结转移风险相关的临床病理特征

pT1b期分化型早期胃癌淋巴结转移风险相关的临床病理特征

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目的 探讨pT1b期分化型早期胃癌(EGC)淋巴结转移风险相关的临床病理特征.方法 选取 2011年 1 月—2023 年 5 月江苏省中医院和当涂县人民医院病理科连续入组的pT1b期EGC患者,共 163 例.收集临床资料,根据患者有无淋巴结转移和肿瘤浸润深度进行分层分析,比较性别、年龄、肿瘤位置、大体类型、肿瘤大小、溃疡、肿瘤浸润深度、组织学类型、肿瘤分化、Tumor Budding(TB)分级、脉管癌栓、神经侵犯及幽门螺杆菌感染状态.结果 pT1b期分化型EGC患者的淋巴结转移率为 15.3%(25/163).单因素分析显示,淋巴结转移阴性组与阳性组患者的肿瘤浸润深度、组织学分化、TB分级、脉管癌栓比较,差异有统计学意义(P<0.05).多因素分析显示,脉管癌栓和高级别TB是淋巴结转移的独立危险因素,且两者呈正相关(r=0.239,P=0.005).虽然浸润深度达pT1b-SM2 的分化型 EGC 淋巴结转移风险比 pT1b-SM1 高,但差异无统计学意义(OR = 2.633,P = 0.229).分层分析发现:48 例pT1b-SM1 期分化型EGC仅 2 例发生淋巴结转移(4.2%),而 115 例pT1b-SM2 期分化型EGC的淋巴结转移率为 20.0%.pT1b-SM2 期患者中淋巴结转移阳性组与阴性组的脉管癌栓和TB分级比较,差异有统计学意义(P<0.05),而高级别TB和脉管癌栓是淋巴结转移的独立危险因素.结论 浸润深度达pT1b-SM2 不是pT1b期分化型EGC发生淋巴结转移的绝对危险因素,不伴有脉管癌栓、高级别 TB及溃疡的pT1b期分化型EGC适合内镜下治疗.
Clinicopathological characteristics of lymph node metastasis in patients with pT1b differentiated early gastric cancer
Objective To investigate the clinicopathological characteristics of lymph node metastasis(LNM)in patients with pT1b differentiated early gastric cancer(EGC).Methods A total of 163 patients with pT1b differentiated EGC who were included in Department of Pathology,Jiangsu Province Hospital of Chinese Medicine and the People's Hospital of Dangtu County from January 2011 to May 2023 were selected.Their clinical data were collected for stratified analysis,according to the presence of LNM and the depth of invasion.The following data were compared,such as gender,age,the location of tumor,macroscopic type,tumor size,ulcer,the depth of invasion,histological type,histological classification,tumor budding(TB)grade,lymphovascular invasion(LVI),perineural invasion,and Helicobacter pylori infection.Results The LNM incidence was 15.3%(25/163)in patients with pT1b differentiated EGC.Univariate analysis results indicated statistical differences in the depth of invasion,histological differentiation,TB grade and LVI between the LNM positive and negative groups(P<0.05).Multivariate analysis showed that LVI and high-grade TB were the independent risk factors for LNM,which were also positively correlated(r=0.239,P=0.005).Although the LNM rate in the pT1b-SM2 group was higher than that in the pT1b-SM1 group,no statistical difference was found(OR=2.633,P= 0.229).According to stratified analysis,the LNM rate was 4.2%(2/48)for patients with pT1b-SM1 differentiated EGC and 20.0%for patient with pT1b-SM2 differentiated EGC.For patient with pT1b-SM2 differentiated EGC,statistical differences were found in LVI and TB grades between the LNM positive and negative groups(P<0.05),while high-grade TB and LVI were the independent risk factors for LNM.Conclusions pT1b-SM2 invasion is not an absolute LNM risk factor for pT1b differentiated EGC.pT1b differentiated EGC patients with LVI and high-grade TB are suitable for endoscopic treatment.

pT1b early gastric cancerdifferentiated gastric cancerlymph node metastasisclinicopathological characteristiclymphovascular invasion

梅静、徐四海、芮军、赵明明、王珝、王耀辉

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当涂县人民医院病理科,安徽 马鞍山 243100

当涂县人民医院普外科

江苏省中医院病理科,江苏 南京 210029

pT1b期早期胃癌 分化型胃癌 淋巴结转移 临床病理特征 脉管癌栓

江苏省中医院院级项目

Y21047

2024

徐州医科大学学报
徐州医学院

徐州医科大学学报

CSTPCD
影响因子:0.395
ISSN:2096-3882
年,卷(期):2024.44(3)
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