Mixed Histology Is a Risk Factor for Lymph Node Metastasis in Early Gastric Cancer

被引:31
作者
Seo, Ho Seok [1 ]
Lee, Go Eun [1 ]
Kong, Min Gon [1 ]
Han, Kyu Hun [1 ]
Jung, Eun Sun [2 ]
Song, Kyo Young [1 ]
机构
[1] Catholic Univ Korea, Coll Med, Dept Surg, Div Gastrointestinal Surg, Seoul, South Korea
[2] Catholic Univ Korea, Coll Med, Dept Hosp Pathol, Seoul, South Korea
关键词
Lymph nodes; Lymphatic metastasis; Stomach neoplasms; Adenocarcinoma; Histology; ENDOSCOPIC RESECTION; GASTRECTOMY; SURGERY; CLASSIFICATION; DISSECTION; RECURRENCE;
D O I
10.1016/j.jss.2018.11.055
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The risk factors of lymph node (LN) metastasis are important factors to consider in endoscopic submucosal dissection in early gastric cancer (EGC). The aim of the study was to identify the correlation between mixed histology and LN metastasis in EGC. Methods: A total of 1645 patients who underwent curative radical gastrectomy for EGC were divided into three groups (pure differentiated [pure D], mixed, and pure undifferentiated [pure UD]) according to histologic type. They were subsequently analyzed retrospectively for LN metastasis. The patients who had mixed histology between differentiated and undifferentiated tubular adenocarcinoma were defined as mixed group. Results: The pure UD group was significantly younger than the other groups. Tumor size was larger in the mixed group. LN metastasis occurred more frequently in the mixed group and the pure UD group than in the pure D group (pure D, mixed, and pure UD, 7.7%, 23.2%, and 10.8%, respectively; P < 0.001). A logistic regression analysis revealed that the independent risk factors for LN metastasis were large tumor size (odd ratio [OR], 1.308), submucosal invasion (OR, 3.565), lymphovascular invasion (OR, 9.755), and histologic types of mixed (OR, 2.360) and pure UD (OR, 1.657). Conclusions: Mixed histology is an important risk factor for LN metastasis in EGC. Thus, radical gastrectomy should be considered in the cases of mixed-type histology after endoscopic resection. (C) 2018 Elsevier Inc. All rights reserved.
引用
收藏
页码:271 / 277
页数:7
相关论文
共 34 条
[1]  
Amin MB., 2016, AJCC Cancer Staging Manual, V8th
[2]   Risk factors of lymph node metastasis in 1620 early gastric carcinoma radical resections in Jiangsu Province in China: A multicenter clinicopathological study [J].
Chen, Ling ;
Wang, Yao Hui ;
Cheng, Yu Qing ;
Du, Ming Zhan ;
Shi, Jiong ;
Fan, Xiang Shan ;
Zhou, Xiao Li ;
Zhang, Yi Fen ;
Guo, Ling Chuan ;
Xu, Gui Fang ;
He, Ya Min ;
Zhou, Dan ;
Zou, Xiao Ping ;
Huang, Qin .
JOURNAL OF DIGESTIVE DISEASES, 2017, 18 (10) :556-565
[3]   Risk Factors and Tumor Recurrence in pT1N0M0 Gastric Cancer after Surgical Treatment [J].
Choi, Hee Jun ;
Kim, Su Mi ;
An, Ji Yeong ;
Choi, Min-Gew ;
Lee, Jun Ho ;
Sohn, Tae Sung ;
Bae, Jae Moon ;
Kim, Sung .
JOURNAL OF GASTRIC CANCER, 2016, 16 (04) :215-220
[4]   Comparison of quality of life and worry of cancer recurrence between endoscopic and surgical treatment for early gastric cancer [J].
Choi, Jae Hyuk ;
Kim, Eun Soo ;
Lee, Yoo Jin ;
Bum, Kwang ;
Park, Kyung Sik ;
Jang, Byoung Kuk ;
Chung, Woo Jin ;
Hwang, Jae Seok ;
Ryu, Seung Wan .
GASTROINTESTINAL ENDOSCOPY, 2015, 82 (02) :299-307
[5]   The Risk Factors of Lymph Node Metastasis in Early Gastric Cancer [J].
Fang, Wen-Liang ;
Huang, Kuo-Hung ;
Lan, Yuan-Tzu ;
Chen, Ming-Huang ;
Chao, Yee ;
Lo, Su-Shun ;
Wu, Chew-Wun ;
Shyr, Yi-Ming ;
Li, Anna Fen-Yau .
PATHOLOGY & ONCOLOGY RESEARCH, 2015, 21 (04) :941-946
[6]   Evaluation of the necessity for gastrectomy with lymph node dissection for patients with submucosal invasive gastric cancer [J].
Gotoda, T ;
Sasako, M ;
Ono, H ;
Katai, H ;
Sano, T ;
Shimoda, T .
BRITISH JOURNAL OF SURGERY, 2001, 88 (03) :444-449
[7]   Endoscopic resection of early gastric cancer [J].
Gotoda, Takuji .
GASTRIC CANCER, 2007, 10 (01) :1-11
[8]   Incidence of lymph node metastasis from early gastric cancer: Estimation with a large number of cases at two large centers [J].
Gotoda T. ;
Yanagisawa A. ;
Sasako M. ;
Ono H. ;
Nakanishi Y. ;
Shimoda T. ;
Kato Y. .
Gastric Cancer, 2000, 3 (4) :219-225
[9]   Comparative study between endoscopic submucosal dissection and surgery in patients with early gastric cancer [J].
Hahn, Kyu Yeon ;
Park, Chan Hyuk ;
Lee, Yong Kang ;
Chung, Hyunsoo ;
Park, Jun Chul ;
Shin, Sung Kwan ;
Lee, Yong Chan ;
Kim, Hyoung-Il ;
Cheong, Jae-Ho ;
Hyung, Woo Jin ;
Noh, Sung Hoon ;
Lee, Sang Kil .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2018, 32 (01) :73-86
[10]   Mixed-histologic-type submucosal invasive gastric cancer as a risk factor for lymph node metastasis: feasibility of endoscopic submucosal dissection [J].
Hanaoka, N. ;
Tanabe, S. ;
Mikami, T. ;
Okayasu, I. ;
Saigenji, K. .
ENDOSCOPY, 2009, 41 (05) :427-432