潮汕地区贲门癌淋巴结转移与临床病理特征的关系

摘要

目的 分析潮汕地区贲门癌淋巴结转移规律及其与临床病理特征的关系.方法 随机选取汕头大学医学院第一附属医院收治的进行外科手术治疗的贲门癌病例304例,建立临床病理资料数据库.选取年龄、性别、肿瘤长径、大体类型、分化程度、浸润深度、标本切缘7个临床病理特征因素,应用Logistic 回归分析方法,分析其与淋巴结转移之间的相关性.结果 304例患者共清扫淋巴结2 844枚,平均清扫9.36枚/例,总转移度为28.9％ (822/2 844),总转移率为44.5％ (275/618).淋巴结转移部位包括腹腔和胸腔,腹腔淋巴结的转移度和转移率均明显高于胸腔淋巴结,差异有统计学意义[29.4％(807/2 749)比15.8％ (15/95),46.3％ (266/574)比20.5％ (9/44),P＜0.01].多因素Logistic回归分析提示肿瘤长径和分化程度与淋巴结转移相关[OR=2.898,95％ CI:1.446～5.807,P=0.003;OR=1.763,95％ CI:1.053～2.950,P=0.031].结论 贲门癌淋巴结转移既向腹腔转移也向胸腔转移,主要以腹腔转移为主.肿瘤长径和分化程度与贲门癌淋巴结转移相关.%Objective To observe relationship between lymph node metastases and clinicopathological features of gastric cardia cancer in Chaoshan area.Methods Clinical data from 304 patients with gastric cardia cancer were collected.The age, sex, maximum tumor diameter, gross type, differentiation degree, depth of tumor invasion, and status of surgical margins were recorded and their correlations with the clinicopathological features were analyzed by Logistic regression Analysis.Results In 304 patients, totally 2 844 lymph nodes were retrieved with average number of 9.36/case;the lymph node metastasis ratio was 28.9％ (822/2 844) and metastasis rate was 44.5％ (275/618).The metastasized lymph node included abdominal and thoracic lymph nodes, the metastasis ratio and metastasis rate of abdominal lymph nodes were significantly higher than those of thoracic lymph nodes [29.4％ (807/2 749) vs 15.8％ (15/95), 46.3％ (266/574) vs 20.5％ (9/44)] (P＜0.01).Multiple factors Logistic regression analysis showed that the maximum tumor diameter and differentiation degree were correlated with lymphatic metastasis [OR =2.898, 95％ CI: 1.446-5.807, P =0.003;OR =1.763, 95％ CI: 1.053-2.950, P =0.031].Conclusions Gastric cardia cancer can metastasize to abdominal and thoracic lymph nodes, mainly to abdominal lymph nodes;maximum tumor diameter and tumor differentiation degree are correlated with lymoh node metastases.