Impact of malignant ulcer size on lymph node stages in gastric cancer with ulcerative growth.
OBJECTIVE
Although malignant ulcers have been documented in gastric cancer, the specific relationship between ulcer size and lymph node stages in gastric cancer remains uncertain. The aim of this study was to investigate the relationship between ulcer size and lymph node stages in gastric cancer patients.


METHODS
The diameter of the malignancy ulcer was measured, the patients were divided into three groups based on the presence of ulcer and its median size: U0 no ulcer; U1 ulcer size 0-3cm, U2 the ulcer size >3cm. Univariate and multivariate analyses were performed.


RESULTS
The distribution of lymph node stages differed significantly between U0 and U1+U2 (p<0.001), and the similar difference was present between U1 and U2 (p<0.001). In all patients, the presence of ulcer correlated with lymph node stages (pN- vs. pN+). In ulcerative gastric cancer patients the stage pN2-3 was more common in patients with U2 (14.1%, 19/135) than in U1 (6.4%, 12/188; p< 0.001). A logistic regression model revealed that lymph node metastases were associated with presence of malignant ulcer (p=0.002), and the ulcer size still emerges as a significant variable ulcer size in ulcerative cancer (p=0.022).


CONCLUSIONS
For gastric cancer patients, the presence of ulcer and ulcer size might be a potential biomarker of lymph node metastasis.
Department of Breast and Throid Surgery, Shaoxing People's Hospital, Shaoxing, China.
Chaoyang
C
Xu
Jiangguo
J
Shen
Shuduo
S
Xie
Zhinong
Z
Jiang
Wenjun
W
Chen
Linbo
L
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D013276:Stomach Ulcer / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden