| Objective: Gastric cancer is the most common malignant tumor in our country. Each year the number of deaths from cancer of the stomach malignant tumors is in the first place. And, the mortality of gastric cancer is second only to lung cancer. In recent years, although a slight decline in some large and medium cities in China, the mortality rates remain high. Gastric cancer is one of the malignant tumor which is still a serious threat to the people’s life and health at present. It is recognized currently that lymph node metastasis is the most important way to gastric cancer spread and the most important factors influencing curative effect and prognosis of gastric cancer surgery. Because the survival quality and survival rate of gastric cancer in the early can be increased significantly, so early diagnosis and treatment is the key to improve the effect of treatment of gastric cancer. In recent years, with the improvement of the wide application of endoscopy and operation technology, the detection rate of early gastric cancer in our country is also improved. Also, the treatment of early gastric cancer has become the focus of people. With the development of the imes, to improve security, improve radical and strongly reduction surgery, reduce the trauma, to improve the quality of life on the basis of the guarantee survival rate and to do reasonable range of lymph node cleaning is now the main direction of gastric cancer treatment in nowdays with what the surgical treatment of early gastric cancer can be more reasonable and standard. This paper discusses the law of lymph node metastasis of early gastric cancer, which refers to guide early gastric cancer endoscopic treatment or laparoscopic surgery and surgical treatment for the purpose of cleaning, tiese can provide evidence-based medicine basis for reasonable surgical treatment.Methods: Collect 908 qualified early gastric cancer patients who wereadmitted into general surgery department of NO.4 Hospital affiliated HebeiMedical university from Mon.1969 to Dec 2013. We analyze its clinical dataand related pathological findings to do statistical analysis and comparison,and analysis the clinical pathologic factors associated with lymph nodemetastasis. These data are statistically described and analysed by softwareSPSS 19.0 and P<0.05 indicates stastistical significance.Results: Collect 908 qualified early gastric cancer patients who wereadmitted into general surgery department of NO.4 Hospital affiliated HebeiMedical university from Mon.1969 to Dec 2013 719 male aged from 19 to 82(average 58.62), 179 female ages from 24 to 76(average 54.55), the male tofemale ratio is 3.80 to 1. In terms of location, there are cardia cases 401, 121body of stomach cases, 344 antrum of stomach cases, 32 total stomach cases.1 The total Matastasis rate of early gastric cancerThere are 103 cases which have Lymph node metastasis confirmed by Postopeprative pathology in 908 cases, and the total metastasis rate in 11.34%. The 3 rd group has the highest metastasis rate, higher than group6, group 7, group 4, group 8, and group1, group 5, group 2, group 9, group 11, and group 12, group 10, group 14, group 16, the metastasis rate is 38.83%, 29.91%, 28.16%, 22.33%, 11.65%, 11.65%, 6.80%, 4.85%, 4.85%, 2.91%, 0.97%, 0.97%, 0.97%, 0.97%, According to χ2 test, χ2=170.693, P=0.000, P<0.05, statistically significant.2 Metastasis rate of different sex619 cases of male patients, 67 cases behave lymph bode confirmed by pathology,the metastasis rate is 10.82%.289 cases of famale patients, 36 cases behave lymph bode confirmed by pathology,the metastasis rate is 12.46%.According to χ2 test, χ2=0.522, P=0.470, P>0.05, no statistically significance.3 Metastasis rate of different ages562 cases of early gastric cancer patients over the age of 60, 58 cases behave lymph bode confirmed by pathology, the metastasis rate is 10.32%.346 cases of early gastric cancer patients under the age of 60, 45 cases behave lymph bode confirmed by pathology,the metastasis rate is 13.01%.According to χ2 test, χ2=1.536, P=0.215, P>0.05, no statistically significance.4 Metastasis rate of different sizes of the tumors215 cases of patients with early gastric cancer tumors less than 2 cm in diameter, 14 cases behave lymph bode confirmed by pathology, the metastasis rate is 6.51%.693 cases of patients with early gastric cancer tumor greater than 2 cm in diameter, 63 cases behave lymph bode confirmed by pathology, the metastasis rate is 12.84%.According to χ 2 test, χ 2 =6.540, P=0.011, P < 0.05, statistically significance.5 Metastasis rate of different locations401 cardia cases, 48 cases behave lymph bode confirmed by pathology, the metastasis rate is 15.71%.121 body of stomach cases, 15 cases behave lymph bode confirmed by pathology, the metastasis rate is 14.88%.344 antrum of stomach cases, 41 cases behave lymph bode confirmed by pathology, the metastasis rate is 16.86%.32 total stomach cases, 4 cases behave lymph bode confirmed by pathology,the metastasis rate is 12.5%.According to χ2 test, χ2=0.618, P=0.892, P>0.05, no statistically significance.6 Metastasis rate of different general types114 cases of early gastric cancer patients with type I(uplift type), 11 cases behave lymph bode confirmed by pathology, the metastasis rate is 9.65%.478 cases of early gastric cancer patients with type II(superficial type), 42 cases behave lymph bode confirmed by pathology, the metastasis rate is 8.79%.316 cases of early gastric cancer patients with type III(SAG type), 50 cases behave lymph bode confirmed by pathology, the metastasis rate is15.82%.According to χ 2 test, χ 2 =9.737, P=0.008, P < 0.05, statistically significance.7 Metastasis rate of different histological types206 cases of patients with poorly differentiated carcinoma, 61 cases behave lymph bode confirmed by pathology, the metastasis rate is 29.61%.702 cases of patients with the early gastric cancer to differentiate good, 42 cases behave lymph bode confirmed by pathology, the metastasis rate is 5.98%.According to χ 2 test, χ 2 =88.418 P=0.000, P < 0.05, statistically significance.8 Metastasis rate of different infiltration depth457 cases of patients with intramucosal carcinoma, 27 cases behave lymph bode confirmed by pathology, the metastasis rate is 5.91%.451 cases of patients with submucosal carcinoma, 76 cases behave lymph bode confirmed by pathology, the metastasis rate is 16.85%.According to χ 2 test, χ 2 =27.030 P=0.000, P < 0.05, statistically significance.9 Multiple factors analysis of lymph node metastasis variablesAccording to χ2 test, the impact of tumor size, histological type and infiltration depth was statistically significant. Multi-factor anal(using Logistic regression model)showed that:the regression coefficients of tumor size, histological type and infiltration depth was-0.596(P=0.015), 0.608(P=0.006),-1.233(P=0), P<0.05, statistically significance.Conclusions: In this paper, we statistically analyze 908 clinical cases and conclude as follows:1 The lymph node metastasis rate of early gastric cancer patients was 11.34%.2 The lymph node metastasis rate of male patients with early gastric cancer was 10.82%. The lymph node metastasis rate of women patients with early gastric cancer was 12.46%. The lymph node metastasis rate of early gastric cancer between different gender has no obvious difference, but there is a tendency which women is higher than male.3 The lymph node metastasis rate of early gastric cancer patients over the age of 60 was 10.32%. The lymph node metastasis rate of early gastric cancer patients under the age of 60 was 13.01%. The lymph node metastasis rate of the patients under the age of 60 is higher than the patients over the age of 60, but it is not obvious.4 The lymph node metastasis rate of early gastric cancer of cardia was 15.71%. The lymph node metastasis rate of early gastric cancer of gastric body was 14.88%. The lymph node metastasis rate of early gastric cancer of gastric antrum was 16.86%. The oeder of lymph node metastasis rate from high to low is :gastric antrum, cardia, gastric body.5 Thelymph node metastasis rate of early gastric cancer greater than 2 cm in diameter was 12.84%. Thelymph node metastasis rate of early gastric cancer less than 2 cm in diameter was 6.51%. Thelymph node metastasis rate of early gastric cancer greater than 2 cm in diameter is higher than that less than 2 cm in diameter.6 The lymph node metastasis rate of type I cancer of the stomach was 9.65%. The lymph node metastasis rate of type II cancer of the stomach was 8.79%. The lymph node metastasis rate of type III cancer of the stomach was 15.82%. The lymph node metastasis rate of type III cancer of the stomach were higher htan type I and type II.7 The lymph node metastasis rate of early gastric cancer with poor differentiation was 29.61%. It is significantly higher than the lymph node metastasis rate(5.98%) of early gastric cancer to differentiate good.8 The lymph node metastasis rate of early gastric cancer limited to the mucosal lining was 5.91%.It is significantly lower than the lymph node metastasis rate(16.85%) of early gastric cance under the mucous membrane.9 The early gastric cancer lymph node metastasis rate of groups 3, 6, 7, 4 group is higher than other groups. |
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