Clinicopathological characteristics of lymph node metastasis in patients with pT1b differentiated early gastric cancer

Objective To investigate the clinicopathological characteristics of lymph node metastasis (LNM) in patients with pT1b differentiated early gastric cancer (EGC).Methods A total of 163 patients with pT1b differentiated EGC who were included in Department of Pathology, Jiangsu Province Hospital of Chinese Medicine and the People's Hospital of Dangtu County from January 2011 to May 2023 were selected. Their clinical data were collected for stratified analysis, according to the presence of LNM and the depth of invasion. The following data were compared, such as gender, age, the location of tumor, macroscopic type, tumor size, ulcer, the depth of invasion, histological type, histological classification, tumor budding (TB) grade, lymphovascular invasion (LVI), perineural invasion, and Helicobacter pylori infection.Results The LNM incidence was 15.3% (25/163) in patients with pT1b differentiated EGC. Univariate analysis results indicated statistical differences in the depth of invasion, histological differentiation, TB grade and LVI between the LNM positive and negative groups (P＜0.05). Multivariate analysis showed that LVI and high-grade TB were the independent risk factors for LNM, which were also positively correlated (r=0.239, P=0.005). Although the LNM rate in the pT1b-SM2 group was higher than that in the pT1b-SM1 group, no statistical difference was found (OR=2.633, P=0.229). According to stratified analysis, the LNM rate was 4.2% (2/48) for patients with pT1b-SM1 differentiated EGC and 20.0% for patient with pT1b-SM2 differentiated EGC. For patient with pT1b-SM2 differentiated EGC, statistical differences were found in LVI and TB grades between the LNM positive and negative groups (P＜0.05), while high-grade TB and LVI were the independent risk factors for LNM.Conclusions pT1b-SM2 invasion is not an absolute LNM risk factor for pT1b differentiated EGC. pT1b differentiated EGC patients with LVI and high-grade TB are suitable for endoscopic treatment.