Clinical analysis of early gastric carcinoma in 101 patients

Abstract

Objective To investigate the principle of lymph nodes metastasis (LNM) in early gastric carcinoma (EGC),and try to provide theoretical basis for individualized treatment. Methods One hundredand one patients were operated upon due to EGC, all clinicopathologic data were analyzed retrospectively. Results LNM was detected in 16 cases with lesion in lower stomach, the incidence of LNM was 15.8%. LNM correlated with depth of infiltration, tumor size and pathological type. The rate of LNM was 27.9% in SM2 ,significantly higher than that in M(2.8%) and SM(13.6%),P0.05.The incidence increased along with the increment of tumor size, no LNM was found in minute gastric cancer (MGC),5.0% in small gastric cancer(SGC),14.8% in patients with 1.1-2.0 cm lesion in diameter and 27.5% in greater than 2.0 cm (P0.05).Well-differentiated EGC without LNM, while the risk was 17.2%,19.6% for moderate- and poor- differentiated respectively. The research showed that, in levelⅠ tier lymph nodes (LN),the risk of No.3 LN involvement reached up to 50.0%, followed by No.6(37.5%), No.4(31.3%) and No.5(12.5%).In levelⅡ, the risk decreased gradually by 25.0%,12.5%,6.3% for No.7,8 a,9 LN respectively. In our series, M and SM1 involved level I tier LN, but levelⅡ tier LN involvement obviously increased in SM2.MGC without LNM, SGC involved level I tier LN only. Nevertheless the rate of levelⅡ tier LN involvement rose in patients with lesion greater than 1.1 cm in diameter. As the same that, no LNM in well-differentiated cancer, the risk of levelⅡ increased accompanying the worsening of differentiation. Conclusions The cognition to principle of LNM, especially the EGC in lower stomach, contribute to individualized surgery therapy and offer theoretical support for microinvasive operation.