Pattern Of Lymph Node Metastases And Its Implication In Radiotherapeutic Clinical Target Volume Delineation Of Regional Lymph Node In Patients With Advanced Gastric Cancer

Objective:To instruct the ridiotherapiutic clinical target volum delineation of gastric cancer by studying the rules of the lymph nodes metastasis.Methods:The basal information and postoperative pathology of the gastric cancer patients who have undergone radical gastrectomy in Shandong Tumor Hospital was collected from March,2013 to March,2015.The risk factors for lymph node metastasis were calculated by through multivariate logistic regression.The relation between lymph nodes was evaluated through binary logistic regression.Results:The frequency of lymph node from group 1 to group 2 is as following:No1 39.4%,No2 23%,No3 68.4%,No4 40.4%,No5 41.4%,No6 35.8%,No7 42.1%,No8 24.1%,No9 17%,No10 9.7%,No11 6.1%,No12 13.9%,No13 2.7%,No14 4.6%,No15 1.7%,respectively.The risk factors for lymph node metastasis from group 1 to group 15 are as following respectively, No 1:Tumor location, Borrmann type, Tumor diameter; No2:T stage, Tumor location, Borrmann type, Tumor diameter; No3:T stage, Borrmann type, Tumor diameter; No4:T stage, Differentiated digree, Tumor diameter; No5:T stage, Tumor location, Bormann type, Tumor diameter; No6:T stage, Tumor location, Bormann type, Tumor diameter; No7:T stage, Bormann type, Differentiated digree, Tumor diameter, Agedness; No8:Tumor location, Bormann type, Tumor diameter; No9: Differentiated digree, Tumor diameter; No10:Bormann type, gender; No11:CEA level, Bormann type; No12:Tumor diameter. The lymph node related risk factors between lymph nodes are as following,No1:No2,No3,No7,No8,No12;No2:No1,No4,No5,No6;No3:No1,No2,No6;No4:No2,No3,No5,No10,No12;No5:No2,No4,No6,No7;No6:No2,No3,No5;No7:No1,No5,No8;No8:No1,No2,No3,No5,No9,No11,No12,No13;No9:No1,No2,No8,No12;No10:No2,No4,No11,N o12,No15;No11:No1,No3,No8,No10,No12;No12:No1,No4,No9,No10,No11;No14:No2.Conclusions:The risk factors for lymph node metastasis between lymph nodes are different.The risk factors for a single lymph node can instruct the preoperative radiotherapy.The lymph node related risk factors are different between lymph nodes,according which,we can deduce the suspicious positive lymph node and include it in the ridiotherapiutic clinical target volum delineation.