摘要：

AIM:The prognosis of early gastric carcinoma (EGC) isgenerally excellent after surgery.The presence or absenceof lymph node metastasis in EGC is an important prognosticfactor.The survival and recurrence rates of node-negativeEGC are much better than those of node-positive EGC.Thisstudy examined the factors related to lymph node metastasisin EGC to determine the appropriate treatment for EGC.METHODS:We investigated 748 patients with EGC whounderwent surgery between January 1985 and December1999 at the Division of Gastroenterologic Surgery,Departmentof Surgery,Chonnam National University Hospital.Severalclinicopathologic factors were investigated to analyze theirrelationship to lymph node metastasis:age,sex,tumorlocation,tumor size,gross type,histologic type,depth ofinvasion,extent of lymph node dissection,type of operation,and DNA ploidy.RESULTS:Lymph node metastases were found in 75patients (10.0%).Univariate analysis showed that malesex,tumor size larger than 2.0 cm,submucosal invasion oftumor,histologic differentiation,and DNA ploidy pattern wererisk factors for regional lymph node metastasis in EGCpatients.However,a multivariate analysis showed that threerisk factors were associated with lymph node metastasis:large tumor size,undifferentiated histologic type andsubmucosal invasion.No statistical relationship was foundfor age,sex,tumor location,gross type,or DNA ploidy inmultivariate analysis.The 5-year survival rate was 94.2%for those without lymph node metastasis and 87.3% forthose with lymph node metastasis,and the difference wassignificant (P0.05).CONCLUSION:In patients with EGC,the survival rate ofpatients with positive lymph nodes is significantly worse thanthat of patients with no lymph node metastasis.Therefore,a standard D2 lymphadenectomy should be performed inpatients at high risk of lymph node metastasis:large tumorsize,undifferentiated histologic type and submucosal invasion.

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