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首页> 外文期刊>World Journal of Surgical Oncology >Clinicopathological features and risk factors analysis of lymph node metastasis and long-term prognosis in patients with synchronous multiple gastric cancer
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Clinicopathological features and risk factors analysis of lymph node metastasis and long-term prognosis in patients with synchronous multiple gastric cancer

机译：同步多胃癌患者淋巴结转移和长期预后的临床病理特征及危险因素分析

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As a common malignancy, gastric cancer (GC) remains an important threat to human’s health. The incidence of synchronous multiple gastric cancer (SMGC) has increased obviously with technical advances of endoscopic and pathological examinations. Several studies have investigated the relationship between SMGC and solitary gastric cancer (SGC). However, little is known about the relationship between early and advanced SMGCs, and the independent risk factors of lymph node metastasis and prognosis in SMGC patients remain unclear. We retrospectively collected 57 patients diagnosed as SMGC and underwent radical gastrectomies from December 2011 to September 2019. Epidemiological data and clinicopathological characteristics of all patients were recorded. Postoperative follow-up was performed by telephone or outpatient service. Chi-squared test or Fisher’s exact test was adopted in analysis of categorical data. Continuous data were analyzed by using unpaired t test. Univariate and multivariate analyses were performed to investigate the independent risk factors of lymph node metastasis and tumor recurrence of SMGC. There were 45 males and 12 females. The average age was 62.1 years old. There were 20 patients with early SMGC and 37 patients with advanced SMGC. Most of patients (91.2%) had two malignant lesions. Tumor recurrence occurred in 8 patients, among which 7 patients died from recurrence. The rates of total gastrectomy, tumor size ≥ 2 cm, poorly differentiated type, lymph node metastasis, ulcer and nerve invasion, and preoperative CEA level were significantly higher in advanced SMGC patients compared to those with early SMGC. Lymphovascular cancer plug and preoperative CA125 were the independent risk factors of lymph node metastasis in patients with SMGC. Lymph node metastasis, nerve invasion, and preoperative AFP might be the risk factors of tumor recurrence of SMGC, but need further validation. In patients with SMGC, the presence of tumor size ≥ 2 cm, poorly differentiated type, lymph node metastasis, ulcer, nerve invasion, and relatively high preoperative CEA level might indicate the advanced SMGC. More attention should be paid to lymph node metastasis in SMGC patients with lymphovascular cancer plug and high preoperative CA125. Lymph node metastasis, nerve invasion, and preoperative AFP might be associated with recurrence of SMGC, needing further validation.
机译：作为一种常见的恶性肿瘤，胃癌（GC）仍然是对人类健康的重要威胁。同步多胃癌（SMGC）的发生率明显增加了内镜和病理检查的技术进步。几项研究研究了SMGC和孤立胃癌（SGC）之间的关系。然而，关于早期和高级SMGC之间的关系知之甚少，并且SMGC患者淋巴结转移和预后的独立危险因素仍不清楚。我们回顾性地收集了57名诊断为SMGC的患者，从2011年12月到2019年9月诊断为SMGC和接受激进胃切除术。记录所有患者的流行病学数据和临床病理特征。术后随访通过电话或门诊服务进行。在分类数据分析中采用了Chi-Squared测试或Fisher的确切测试。通过使用未配对T测试分析连续数据。进行单变量和多变量分析，以研究SMGC淋巴结转移的独立危险因素和肿瘤复发。有45个男性和12名女性。平均年龄为62.1岁。有20例早期SMGC和37例先进的SMGC患者。大多数患者（91.2％）有两个恶性病变。 8例患者发生肿瘤复发，其中7名患者从复发中死亡。与早期SMGC的人相比，总胃切除术的总胃切除术，肿瘤大小≥2厘米，差异较差的类型，淋巴结转移，溃疡和神经侵袭，以及术前CEA水平显着高。淋巴血管癌塞和术前CA125是SMGC患者淋巴结转移的独立危险因素。淋巴结转移，神经侵袭和术前AFP可能是SMGC肿瘤复发的危险因素，但需要进一步验证。在SMGC患者中，肿瘤大小的存在≥2cm，差异不良，淋巴结转移，溃疡，神经侵袭和相对较高的术前CEA水平可能表明先进的SMGC。应更多地注意SMGC淋巴血管癌塞和高术前CA125患者的淋巴结转移。淋巴结转移，神经侵袭和术前AFP可能与SMGC的复发相关，需要进一步验证。

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