Study On Metastasis And Micrometastasis In Splenic Lymph Nodes Of Patients With Middle-Upper Advanced Gastric Cancer

Background and Objective Gastric cancer occur more commonly as a Gastrointestinal tumors, surgery is the only way to curable. Regional lymph node dissection is an essential part of D2 resection, but current surgery lack of a method to accurately evaluate the regional lymph node metastasis or micrometastasis. This study decide to explore the splenic lymph node metastasis(include micrometastasis) in 82 cases of middle-upper gastric cancer, then analysis the splenic lymph node metastasis and micrometastasis rule of upper gastric.It can be a guidance for advanced gastric cancer,as well as an important clinical significance.Methods The clinical and pathological data about 82 cases(total gastrectomy D2 resection) patients is collected from the Third Affiliated Hospital of Anhui Medical University(First People’s Hospital of Hefei and Binhu Hospital) from August 2011 to August 2014, The χ2 test or Fisher’s exact test is used to analyze the clinicopathological variables, such as gender, age, tumor location,tumor size, gross type, histology, depth of invasion, vascular involvement, staging and No.4s metastasis. Multivariate analysis was performed using qualitative data Multivariate logistic regression model, P <0.05 was considered statistically significant.ResultThe rate of splenic lymph node metastasis is 21.95%(18/82). sixty-two patients had no metastasis on conventional pathological examination, of whom 21(32.80%) were found to have micrometastasis.The overall metastatic rate was 47.56%(39/82). Univariate analysis showed that tumor size, TNM stage, Borrmann type, tumor site is laterally related factors for splenic lymph node metastasis, and multivariate analysis confirmed the lateral tumor site, TNM stage, Borrmann classification was an independent risk factor. However,the splenic lymph node micrometastasis were prompted T stage, tumor site is the lateral risk factors.Conclusion TNM stage, Borrmann types, T stage and tumor lateral part is the general risk factors of splenic lymph node metastasis or micrometastasis, but the correlation between No.4s lymphatic invasion, age, gender, tumor size, differentiation and spleen hilar lymph nodes metastasis can not be found. Besides,it imply that the greater curvature, BormannⅢ-Ⅳ type, Ⅲ or ⅳ stage, T3 or T4 middle-upper gastric cancer patients need routine splenic lymph node dissection.