Clinicopathological Characteristics Of Lymph Node Metastasis In Gallbladder Carcinoma

Objectives The purpose of my study was to find out the high risk factors of lymph node metastasis in gallbladder cancer by analyzing the clinical and pathological characteristics of patients with gallbladder cancer,which has an important value for clinical treatment and prognosis evaluation.Methods This retrospective study was conducted on patients with gallbladder cancer who underwent resection between October 01,2012 and January 30,2019.Clinical and pathological data were collected to find out the risk factors of lymph node metastasis in patients with gallbladder carcinoma.Used spss21.0 statistical software,t test of two independent samples was used for measurement data,chi-square test was used for counting data,rank sum test was used for grade data,p < 0.05 was statistically significant in difference analysis.The univariate and multivariate analysis of lymph node metastasis was carried out by using logistic regression model forward model,and the risk factors obtained from univariate analysis were calculated by logistic regression model to calculate the possibility of lymph node metastasis.Results A total of 41 cases of accidental gallbladder carcinoma,with a median age of 63 years,were collected,including 18 males and 23 females,with t stage of 9 cases of tis stage,1 case of T1 a stage,5 cases of T1 b stage,no lymph node metastasis in tis-t1 b stage,4 cases of stage T2,2 cases of lymph node metastasis,22 cases of stage T3,7 cases of lymph node metastasis.The overall lymph node metastasis rate(9 ? 41)was 21.95%.Among them,18 cases were male,5 cases had lymph node metastasis,the rate of lymph node metastasis was 27.78%.Among 23 cases of female,4 cases had lymph node metastasis,the lymph node metastasis rate was 17.39%.There was no significant difference between the two groups(x2 test,p > 0.05).The age of onset was 60.22 ±10.41 years in 9 patients with lymph node metastasis and 63.69 ±12.04 years in 32 patients without lymph node metastasis.There was no significant difference in age in patients with lymph node metastasis of gallbladder cancer.In terms of tumor differentiation,there was no significant difference in the degree of tumor differentiation according to high(high differentiation),middle(middle differentiation,middle and high differentiation)and low(low differentiation,low differentiation).Rank sum test showed that p ? 0.051,p > 0.05,the difference was not statistically significant.In terms of vascular tumor thrombus,there was significant difference between lymph node metastasis group and non-metastasis group(p ? 0.013,p < 0.05,the difference was statistically significant).The probability of lymph node metastasis in patients with vascular tumor thrombus was higher than that in non-metastasis group.There was significant difference between the presence of nerve invasion and lymph node metastasis,p ? 0.027,p < 0.05,that is to say,lymph node metastasis was more likely in the group with nerve invasion.The rank sum test of grade data was used in t stage of tumor,p ? 0.041,p < 0.05,the difference was statistically significant.Univariate binomial logistic regression analysis showed that three variables,vascular tumor thrombus,nerve invasion and tumor t stage,had significant effects on dependent variables.The three variables were included in binary logistic regression for multivariate analysis,and it was concluded that vascular tumor thrombus was an independent risk factor for lymph node metastasis of gallbladder cancer.Furthermore,using multivariate binomial logistic regression analysis,the final model was: logit(p)=-4.63 1.141 of peripheral nerve infiltration 1.432 of intravascular tumor thrombus 0.605 stage.For lymph nodes with positive lymph nodes,peripheral nerve infiltration was 3.131 times higher than that without peripheral nerve infiltration,intravascular tumor thrombus was 4.187 times higher than that without intravascular tumor thrombus,and for each grade increased by stage,the grade was 1.831 times higher than that without intravascular tumor thrombus.Conclusions T stage,nerve infiltration and vascular tumor thrombus are the risk factors of lymph node metastasis in gallbladder carcinoma,especially vascular tumor thrombus is an independent risk factor for lymph node metastasis.The prognosis of patients with tumor thrombus with positive nerve infiltration and late t stage should be combined with adjuvant chemotherapy after operation.Lymph node cleaning or/ and adjuvant chemotherapy should also be performed in patients with accidental gallbladder carcinoma who showed vascular tumor thrombus.Figure 0;Table7;Reference 126...