Risk factors of lymph node metastasis in female early gastric cancer

doi:10.3877/cma.j.issn.1674-0793.2020.02.009

Abstract

Abstract:

Objective

To investigate the risk factors of lymph node metastasis in female patients with early gastric carcinoma.

Methods

The clinicopathological data of one hundred and thirty-six female patients with early gastric cancer from August 2010 to December 2018 in Nanjing Drum Tower Hospital were collected retrospectively. The risk factors of lymph node metastasis were screened by single factor analysis and Logistic regression analysis.

Results

Lymph node metastasis occurred in 28 cases (20.59%), which was related to age, menopause, lauren type, and depth of invasion (P<0.05). Multivariate analysis showed that menopause (P=0.028, OR=2.998, 95% CI: 1.128-7.966) and tumor infiltration depth (P=0.015, OR=3.730, 95% CI: 1.289-10.787) were the risk factors of lymph node metastasis in female patients with early gastric cancer.

Conclusions

The rate of lymph node metastasis is 20.59% in female patients. Premenopausal patients are more likely to have lymph node metastasis. Whether menopause or not and depth of invasion are independent risk factors of lymph node metastasis in female patients with early gastric cancer.

Key words: Stomach neoplasms, Early gastric cancer, Lymphtic metastasis, Female

Benlong Sun, Tingting Ma, Xiewu Qiu, Min Feng, Bo Jiang, Xushun Liu, Fanjie Meng, Wenxian Guan. Risk factors of lymph node metastasis in female early gastric cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(02): 115-117.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2020.02.009

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2020/V14/I02/115

Figures/Tables 2

References 11

[1]	Ono H, Yao K, Fujishiro M, et al. Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer[J]. Dig Endosc, 2016, 28(1): 3-15.
[2]	Zhao BW, Chen YM, Jiang SS, et al. Lymph node metastasis, a unique independent prognostic factor in early gastric cancer[J]. PLoS One, 2015, 10(7): e0129531.
[3]	Choi J, Kim SG, Im JP, et al. Lymph node metastasis in multiple synchronous early gastric cancer[J]. Gastrointest Endosc, 2011, 74(2): 276-284.
[4]	Tong JH, Sun Z, Wang ZN, et al. Early gastric cancer with signet-ring cell histologic type: risk factors of lymph node metastasis and indications of endoscopic surgery[J]. Surgery, 2011, 149(3): 356-363.
[5]	Jin EH, Lee DH, Jung SA, et al. Clinicopathologic factors and molecular markers related to lymph node metastasis in early gastric cancer[J]. World J Gastroenterol, 2015, 21(2): 571-577.
[6]	孙本龙，康星，丁杰, 等. 影响早期胃癌患者淋巴结转移的性别因素分析[J]. 中华普通外科杂志, 2017, 32(1): 26-29.
[7]	Kim JJ, Song KY, Hur H, et al. Lymph node micrometastasis in node negative early gastric cancer[J]. Eur J Surg Oncol, 2009, 35(4): 409-414.
[8]	Japanese Gastric Cancer Association. Japanese Gastric Cancer Treatment Guidelines 2014 (ver. 4)[J]. Gastric Cancer, 2017, 20(1): 1-19.
[9]	Kim YI. Is retrieval of at least 15 lymph nodes sufficient recommendation in early gastric cancer?[J]. Ann Surg Treat Res, 2014, 87(4): 180-184.
[10]	Deng H, Huang X, Fan J, et al. A variant of estrogen receptor-alpha, ER-alpha 36 is expressed in human gastric cancer and is highly correlated with lymph node metastasis[J]. Oncol Rep, 2010, 24(1): 171-176.
[11]	Zhou J, Teng R, Xu C, et al. Overexpression of ERα inhibits proliferation and invasion of MKN28 gastric cancer cells by suppressing β-catenin[J]. Oncol Rep, 2013, 30(4): 1622-1630.

临床病理因素		例数	淋巴结转移	无淋巴结转移	χ²值	P值
例数		136	28	108	?	?
月经状况		?	?	?	7.199	0.007
?	绝经	96(70.59)	14(14.58)	82(85.42)	?	?
?	未绝经	40(29.41)	14(35.00)	26(65.00)	?	?
年龄(岁)		?	?	?	4.842	0.028
?	< 65	99(72.79)	25(25.25)	74(74.75)	?	?
?	≥65	37(27.21)	3(8.11)	34(91.89)	?	?
肿瘤部位		?	?	?	4.487	0.213
?	贲门胃底区	25(18.38)	2(8.00)	23(92.00)	?	?
?	胃体	29(21.32)	5(17.24)	24(82.76)	?	?
?	胃窦	75(55.15)	20(26.67)	55(73.33)	?	?
?	多灶	7(5.15)	1(14.29)	6(85.71)	?	?
肿瘤大小(cm)		?	?	?	0.855	0.355
?	< 2	64(47.06)	11(17.19)	53(82.81)	?	?
?	≥2	72(52.94)	17(23.61)	55(76.39)	?	?
大体分型		?	?	?	2.226	0.329
?	息肉型	14(10.29)	3(21.43)	11(78.57)	?	?
?	浅表型	65(47.79)	10(15.38)	55(84.61)	?	?
?	溃疡型	57(41.91)	15(26.32)	42(73.68)	?	?
病理类型		?	?	?	2.615	0.106
?	分化型	52(38.24)	7(13.46)	45(86.54)	?	?
?	未分化型	84(61.76)	21(25.00)	63(75.00)	?	?
Lauren分型		?	?	?	9.520	0.023
?	肠型	38(27.94)	6(15.79)	32(84.21)	?	?
?	混合型	19(13.97)	8(42.11)	11(57.89)	?	?
?	弥漫型	23(16.91)	7(30.43)	16(69.57)	?	?
?	未确定	56(41.18)	7(12.50)	49(87.50)	?	?
浸润深度		?	?	?	4.116	0.042
?	黏膜层	62(45.59)	8(12.90)	54(87.10)	?	?
?	黏膜下层	74(54.41)	20(27.03)	54(72.97)	?	?

临床病理因素		例数	淋巴结转移	无淋巴结转移	χ²值	P值
例数		136	28	108	?	?
月经状况		?	?	?	7.199	0.007
?	绝经	96(70.59)	14(14.58)	82(85.42)	?	?
?	未绝经	40(29.41)	14(35.00)	26(65.00)	?	?
年龄(岁)		?	?	?	4.842	0.028
?	< 65	99(72.79)	25(25.25)	74(74.75)	?	?
?	≥65	37(27.21)	3(8.11)	34(91.89)	?	?
肿瘤部位		?	?	?	4.487	0.213
?	贲门胃底区	25(18.38)	2(8.00)	23(92.00)	?	?
?	胃体	29(21.32)	5(17.24)	24(82.76)	?	?
?	胃窦	75(55.15)	20(26.67)	55(73.33)	?	?
?	多灶	7(5.15)	1(14.29)	6(85.71)	?	?
肿瘤大小(cm)		?	?	?	0.855	0.355
?	< 2	64(47.06)	11(17.19)	53(82.81)	?	?
?	≥2	72(52.94)	17(23.61)	55(76.39)	?	?
大体分型		?	?	?	2.226	0.329
?	息肉型	14(10.29)	3(21.43)	11(78.57)	?	?
?	浅表型	65(47.79)	10(15.38)	55(84.61)	?	?
?	溃疡型	57(41.91)	15(26.32)	42(73.68)	?	?
病理类型		?	?	?	2.615	0.106
?	分化型	52(38.24)	7(13.46)	45(86.54)	?	?
?	未分化型	84(61.76)	21(25.00)	63(75.00)	?	?
Lauren分型		?	?	?	9.520	0.023
?	肠型	38(27.94)	6(15.79)	32(84.21)	?	?
?	混合型	19(13.97)	8(42.11)	11(57.89)	?	?
?	弥漫型	23(16.91)	7(30.43)	16(69.57)	?	?
?	未确定	56(41.18)	7(12.50)	49(87.50)	?	?
浸润深度		?	?	?	4.116	0.042
?	黏膜层	62(45.59)	8(12.90)	54(87.10)	?	?
?	黏膜下层	74(54.41)	20(27.03)	54(72.97)	?	?

危险因素	P值	B	SE	Walds	OR值	OR值的95% CI
月经状态	0.028	1.098	0.499	4.849	2.998	1.128~7.966
肿瘤大小	0.964	0.022	0.497	0.002	1.023	0.386~2.708
肿瘤部位	0.077	-0.576	0.325	3.137	0.562	0.297~1.063
大体分型	0.813	0.089	0.377	0.056	1.093	0.522~2.289
Lauren分型	0.227	0.252	0.208	1.462	1.286	0.855~1.934
病理类型	0.273	-0.670	0.611	1.201	0.512	0.154~1.696
浸润深度	0.015	1.316	0.542	5.901	3.730	1.289~10.787

危险因素	P值	B	SE	Walds	OR值	OR值的95% CI
月经状态	0.028	1.098	0.499	4.849	2.998	1.128~7.966
肿瘤大小	0.964	0.022	0.497	0.002	1.023	0.386~2.708
肿瘤部位	0.077	-0.576	0.325	3.137	0.562	0.297~1.063
大体分型	0.813	0.089	0.377	0.056	1.093	0.522~2.289
Lauren分型	0.227	0.252	0.208	1.462	1.286	0.855~1.934
病理类型	0.273	-0.670	0.611	1.201	0.512	0.154~1.696
浸润深度	0.015	1.316	0.542	5.901	3.730	1.289~10.787

[1]	Shuqin Zhang, Lian Chen. Diagnosis and treatment of postpartum intrauterine retained products of conception [J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(05): 493-497.
[2]	Jie An, Yunfeng Niu, Wei Liu. LINC00520 promoting the invasion and metastasis of gastric cancer through miR-519b-3p/HIF1A axis [J]. Chinese Archives of General Surgery(Electronic Edition), 2024, 18(06): 430-436.
[3]	Guoxin Li, Xinhua Chen. Progress of clinical research on esophagojejunal anastomosis after total laparoscopic gastrectomy [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 1-4.
[4]	Fangpeng Chen, Dawei Yang, Congwen Jin. Effect of laparoscopic proximal gastrectomy combined with modified esophagogastrostomy to reconstruct His Angle in patients with postoperative reflux esophagitis [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 15-18.
[5]	Jie Xu, Yajun Li, Junwei Han. Comparison of the efficacy of radical laparoscopic total gastrectomy in the treatment of overweight gastric cancer with two approaches [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 19-22.
[6]	Liuqing Li, Xiaoxiang Chen, Chengyu Lv. Comparison of total laparoscopic and laparoscopic assisted radical gastrectomy in the treatment of advanced gastric cancer in the near and medium term [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 23-26.
[7]	Shijun Liu, Jie Ma, Lujing Shi. Near-and medium-term follow-up study of complete mesangectomy plus standard D2 radical resection for advanced gastric cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 27-30.
[8]	Jia Ren, Shenghui Ma, Xin Wang, Xiuxia Shi, Shuyun Cai. Clinical observation of laparoscopic total gastrectomy and interposition jejunal gastrectomy [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 31-34.
[9]	Lu Wang, Lijun Zhou. Effects of different anastomotic methods in total laparoscopic distal subtotal gastrectomy on gastric function recovery and complication rate in patients with gastric cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 92-95.
[10]	Hao Chen, Meng Wang. Advances in clinicopathological features and treatment options of sig-ring cell carcinoma of the stomach [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 108-111.
[11]	Bin He, Jinfeng Ma. Risk factors for splenic hilar lymph node metastasis in gastric cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(06): 694-699.
[12]	Mengjie Liang, Huanhuan Zhu, Xingzhou Wang, Hang Jiang, Shichao Ai, Feng Sun, Peng Song, Meng Wang, Song Liu, Xuefeng Xia, Junfeng Du, Shuang Fu, Xiaofeng Lu, Xiaofei Shen, Wenxian Guan. Analysis of prognosis and postoperative complications of gastric cancer patients undergoing conversion therapy with combined immunotherapy [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(06): 619-623.
[13]	Haiwang Liu, Hai Shi, Lifeng Shang. Comparison of different staplers in Roux-en-Y anastomosis during laparoscopic radical gastrectomy for distal gastric cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(06): 643-646.
[14]	Jie Xu, Yajun Li, Yiwen Feng. Comparison of recent follow-up between laparoscopic D2 radical surgery and conventional radical surgery for advanced gastric cancer after SOX neoadjuvant chemotherapy [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(06): 647-650.
[15]	Lijun Zhang, Cunjie Sun, Chunfeng Hu, Chong Meng, Hui Zhang. Accuracy of MSCT and DCE-MRI in evaluating preoperative TNM staging of gastric cancer [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(06): 519-523.

Please choose a citation manager

Content to export