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目的探讨分化型黏膜下胃癌淋巴结转移的危险因素,为EMR术后病理学诊断为黏膜下癌的患者制定合理术式提供理论依据。方法回顾性分析70例分化型黏膜下癌的临床病理资料,分析临床病理特征与淋巴结转移的关系。结果多因素分析表明,淋巴管癌栓和癌灶中存在未分化癌细胞成分(危险因素)与淋巴结转移有关,两指标组间差异有显著性(P<0.05)。两危险因素都存在者,淋巴结转移率为75.0%,无危险因素者,淋巴结转移率为0。在11例26个淋巴结转移的患者中,17个淋巴结转移在N1,9个淋巴结转移超过N1。结论淋巴管癌栓和癌灶中存在未分化癌细胞成分是分化型黏膜下癌淋巴结转移的独立危险因素。对于黏膜内癌行EMR术后病理学检查是黏膜下癌的患者,上述危险因素可作为判断是否需要进行附加手术的简单标准。
Objective To investigate the risk factors of lymph node metastasis in differentiated submucosal gastric cancer and provide a theoretical basis for the development of rational surgical procedures in patients with submucosal carcinoma pathologically diagnosed by EMR. Methods A retrospective analysis of 70 cases of sub-type of sub-type of clinical and pathological data to analyze the relationship between clinicopathological features and lymph node metastasis. Results Multivariate analysis showed that the presence of undifferentiated carcinoma cells in lymphatic tumor thrombus and foci was associated with lymph node metastasis. There was a significant difference between the two groups (P <0.05). Both risk factors exist, the rate of lymph node metastasis was 75.0%, no risk factors, lymph node metastasis rate of 0. Of the 11 patients with 26 lymph node metastases, 17 had lymph node metastases in N1 and 9 lymph nodes exceeding N1. Conclusion The presence of undifferentiated carcinoma cells in lymphatic tumor thrombus and carcinoma is an independent risk factor for differentiated submucosal lymph node metastasis. For intramucosal cancer EMR postoperative pathology is submucosal cancer patients, the above risk factors can be used as a judge to determine whether the need for additional surgery simple standard.