title: Feasible endoscopic therapy for early gastric cancer.
abstract: OBJECTIVE
  To analyze the relationship between lymph node metastasis and clinical pathology of early gastric cancer (EGC) in order to provide criteria for a feasible endoscopic therapy.
  
  
  METHODS
  Clinical data of the 525 EGC patients who underwent surgical operations between January 2009 and March 2014 in the West China Hospital of Sichuan University were analyzed retrospectively. Clinical pathological features were compared between different EGC patients with or without lymph node metastasis, and investigated by univariate and multivariate analyses for possible relationships with lymph node metastasis.
  
  
  RESULTS
  Of the 2913 patients who underwent gastrectomy with lymph node dissection, 529 cases were pathologically proven to be EGC and 525 cases were enrolled in this study, excluding 4 cases of gastric stump carcinoma. Among 233 patients with mucosal carcinoma, 43 (18.5%) had lymph node metastasis. Among 292 patients with submucosal carcinoma, 118 (40.4%) had lymph nodemetastasis. Univariate analysis showed that gender, tumor size, invasion depth, differentiation type and lymphatic involvement correlated with a high risk of lymph node metastasis. Multivariate analysis revealed that gender (OR = 1.649, 95%CI: 1.091-2.492, P = 0.018), tumor size (OR = 1.803, 95%CI: 1.201-2.706, P = 0.004), invasion depth (OR = 2.566, 95%CI: 1.671-3.941, P = 0.000), histological differentiation (OR = 2.621, 95%CI: 1.624-4.230, P = 0.000) and lymphatic involvement (OR = 3.505, 95%CI: 1.590-7.725, P = 0.002) were independent risk factors for lymph node metastasis. Comprehensive analysis showed that lymph node metastasis was absent in patients with tumor that was limited to the mucosa, size ≤ 2 cm, differentiated and without lymphatic involvement.
  
  
  CONCLUSIONS
  We propose an endoscopic therapy for EGC that is limited to the mucosa, size ≤ 2 cm, differentiated and without lymphatic involvement.
authors.affiliation: Tian-Jiao Guo, Jin-Yu Qin, Lin-Lin Zhu, Jin Wang, Jin-Lin Yang, Yi-Ping Wang, Gastroenterology Department of West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Tian-Jiao
authors.initials: TJ
authors.lastname: Guo
authors.affiliation: Tian-Jiao Guo, Jin-Yu Qin, Lin-Lin Zhu, Jin Wang, Jin-Lin Yang, Yi-Ping Wang, Gastroenterology Department of West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Jin-Yu
authors.initials: JY
authors.lastname: Qin
authors.affiliation: Tian-Jiao Guo, Jin-Yu Qin, Lin-Lin Zhu, Jin Wang, Jin-Lin Yang, Yi-Ping Wang, Gastroenterology Department of West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Lin-Lin
authors.initials: LL
authors.lastname: Zhu
authors.affiliation: Tian-Jiao Guo, Jin-Yu Qin, Lin-Lin Zhu, Jin Wang, Jin-Lin Yang, Yi-Ping Wang, Gastroenterology Department of West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Tian-Jiao Guo, Jin-Yu Qin, Lin-Lin Zhu, Jin Wang, Jin-Lin Yang, Yi-Ping Wang, Gastroenterology Department of West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Jin-Lin
authors.initials: JL
authors.lastname: Yang
authors.affiliation: Tian-Jiao Guo, Jin-Yu Qin, Lin-Lin Zhu, Jin Wang, Jin-Lin Yang, Yi-Ping Wang, Gastroenterology Department of West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Wang
mesh_terms: D002454:Cell Differentiation; D016009:Chi-Square Distribution; D002681:China; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005773:Gastroscopy; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016017:Odds Ratio; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Clinical pathological features; Early gastric cancer; Endoscopic therapy; Lymph node metastasis; Risk factor