[Characteristics and risk factors of lymphatic metastasis in early gastric cancer].
OBJECTIVE
To summarize the characteristics of regional lymph node metastasis in patients with early gastric cancer and analyze the risk factors for lymphatic metastasis.


METHODS
103 cases surgically treated for early gastric cancer in the Third Hospital of Peking University between March, 1988 and March, 2009 were analyzed retrospectively. Several clinical pathologic variables including patients' age, gender, size of tumor, tumor location, macroscopic type, histological type, invasion depth were investigated by using chi-square test and logistic regression analysis for the possible relationship to lymphatic metastasis.


RESULTS
The rate of lymph node metastasis in early gastric cancer was 17.5% (18/103), which in mucosal cancer was 4.1% (2/49). Submucosal cancer had a lymph node metastatic rate of 29.6% (16/54). Logistic regression indicated that invasion to submucosa and tumor size > 2 cm were independent risk factors for lymph node metastasis of early gastric cancer. Metastatic cases of mucosal cancer were all signet ring cell cancer with diameters more than 2 cm. Lymph node metastatic rate in submucosal cancers within 2 cm was 16.1%(5/31), that in > 2 cm submucosal cancers was 47.8% (11/23) (P = 0.012). Rate of lymph node metastasis in well-differentiated cancers was 0(0/13), that in moderately-differentiated, poorly differentiated and signet ring cell cancers were 18.2% (4/22), 16.7% (5/30) and 23.7% (9/38) respectively (P = 0.294). Patients' age, gender, tumor location and macroscopic type showed no relationship with lymph node state.


CONCLUSIONS
The tumor size and invasion depth are related with lymph node metastasis in early gastric cancer, considering these factors and assessing lymph node state is essential to appropriate therapeutic options for early gastric cancer.
Wang
Jie-min
JM
Department of Gastroenterology, the Third Hospital, Peking University, Beijing 100191, China.
Zhou
Li-ya
LY
Lin
San-ren
SR
Ding
Shi-gang
SG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology*; D055815:Young Adult