Abstract:Objective:To study the predictive factors of lymph node metastasis in differentiated submucosal gastric cancer (DSMGC), and to establish an objective and rational criteria of indications of endoscopic mucosal resection for DSBGC.
Methods : Clinicopathological data from 70 patients with differentiated submucosal gastric cancer were collected and the relationship between their clinicopathological characteristics and lymph node metastasis was retrospectively analyzed by univariate and multivariate analysis.
Results:Lymphatic vessel tumor emboli and presence of intermingled components of undifferentiated cancer cells (risk factors) were significantly associated with lymph node metastasis(P＜0.05). Patients with both risk factors had lymph node metastasis rate of 75%, patients with no risk factors had no lymph node metastasis.There were 26 lymph node metastases in 11 patients, and 17 of the metastasic lymph nodes were in N1, while 9 metastatic lymph nodes were beyond N1.
Conclusions:Lymphatic vessel tumor emboli and presence of intermingled components of undifferentiated cancer cells were independently related to lymph node metastasis in differentiated submucosal gastric cancer. It is rational for the paitients with one or two independent risk clinicopathological characteristics to undergo an endoscopic mucosal resection.