Influencing Factors Of The Number Of Lymph Node Dissection During Radical Gastric Resection And Its Relationship With Prognosis

Objecive: To discuss the related influencing factors of the number of lymph node dissection in radical gastrectomy,and to explore the relationship between the number of lymph node dissection and the survival rate of patients,so as to provide reference for lymph node dissection in gastric cancer surgery,subsequent evaluation and staging,and to formulate the next treatment plan.Methods: This study collected the general clinical,blood examination and pathological data of 499 patients who underwent D2 radical gastrectomy from January 2016 to December 2017 in the gastrointestinal surgery department of Wannan medical college.Single factor analysis was conducted to determine whether all indicators and the number of lymph nodes were affected,and then the influential factors were included in the multiple linear regression model to obtain their important influential factors.Then,log rank test was used to analyze the relationship between the number of lymph nodes removed and the five-year survival rate of patients in the same tumor size group,tumor location,depth of invasion,PTNM stage.Results: 1.Single factor analysis showed that the number of lymph node dissection was significantly different from the depth of invasion,lymph node metastasis,nerve invasion,vascular tumor thrombus,tumor TNM staging,and the method of gastrectomy,with P<0.05;The number of lymph nodes was not significantly different from sex,age,body mass index(BMI),surgical methods,tumor location,tumor size,carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA),leukocyte,neutrophil to lymphocyte ratio(NLR),platelet,PLR(platelet to lymphocyte ratio),and albumin,and the P value was>0.05.2.Results of multiple linear regression analysis: In the final linear regression model,F=5.523,P < 0.001,which is statistically significant,the regression analysis model results show that nerve infiltration is an important factor in the number of lymph nodes cleared(P<0.05),vascular tumor thrombus,depth of invasion,the method of gastrectomy,and lymph node metastasis are not important factors in the number of lymph nodes cleared(P>0.05).3.Analysis of the relationship between the number of lymph node dissection and prognosis: The number of lymph node dissection was statistically significant with the 5-year survival rate of patients in the T3 stage group,the stage II group and the stage III group.The more the number of lymph node dissection,the higher the survival rate of patients(P<0.05).At the same tumor size,tumor location,T1 stage,T2 stage,T4 stage and pathological stage I,the number of lymph node dissection was not statistically significant with the 5-year survival rate of patients(P>0.05)Conclusion: 1.The number and depth of lymph node dissection,lymph node metastasis,PTNM stage,the method of gastrectomy,whether there is nerve invasion,whether there is vascular tumor thrombus,among which whether there is nerve invasion is an important factor affecting the number of lymph node dissection.2.The survival rate of patients with T1 stage infiltration depth,stage II pathological stage and stage III group is higher with the number of lymph node dissection.