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OBJECTIVE To investigate risk factors of lymph node metastasis (LNM) in early gastric carcinoma (EGC) in four tertiary medical centers in Jiangsu Province, China. METHODS Among 10 097 consecutive combined gastric cancer radical resections, 1903 EGC were identified and reviewed, 283 excluded and 1620 included in the study. All pathological and some endoscopic reports were reviewed for patients' characteristics, tumor location, gross features, and the number of lymph nodes retrieved and involved. Two pathologists independently investigated the pathological features of tumor type, differentiation, invasion depth, lymphovascular invasion (LVI), and perineural invasion. The data were statistically analyzed to identify risk factors for LNM. RESULTS The average number of lymph nodes retrieved was 17.5 per patient. LNM was diagnosed in 15.5%. By univariate analysis, significant risk factors for LNM included age ≥ 41 years, female sex, size over 1 cm, submucosal invasion, poor differentiation, poorly cohesive carcinoma, micropapillary adenocarcinoma, adenocarcinoma mixed with signet-ring cell carcinoma, LVI, perineural invasion, and distal gastric location. By multivariate analysis, independent risk factors for LNM were size ≥ 3 cm (odds ratio [OR] 1.9), poor differentiation (OR 2.5), adenocarcinoma mixed with signet-ring cell carcinoma (OR 1.7), LVI (OR 5.8) and submucosal invasion (OR 2.9). In contrast, size < 3 cm and ulcer were not significant risk factors. Early cardiac carcinoma (OR 0.4) had significantly lower risk. CONCLUSIONS Independent risk factors for LNM in EGC in Chinese patients included tumor size ≥ 3 cm, poor differentiation, submucosal invasion, adenocarcinoma mixed with signet-ring cell carcinoma and LVI. Early cardiac carcinoma had a significantly lower risk for LNM. [ABSTRACT FROM AUTHOR]

Abstract: Background: The combined oral contraceptives (COCs) and intrauterine devices (IUDs) are the most common contraceptive methods used by women. Women''s choices of contraceptive method are largely affected by the safety and efficacy of contraceptive methods as well as by change in women''s quality of life. However, there are still scanty data focusing on the impact of COC or IUD on quality of life in women, especially in China. The aim of this study was to evaluate the impact of desogestrel and ethinyl estradiol tablets (Marvelon) and Yuangong-Cu220 IUD (YCu220 IUD) on quality of life in rural women of the Jiangsu province in China. Study Design: In this prospective cohort study, 784 COC users and 910 YCu220 IUD users were included. The women filled up quality-of-life questionnaires (Quality of Life Enjoyment and Satisfaction Questionnaire) before and after use of contraceptive methods. Results: Significant score changes in physical health, mood, work/school/labor, living situation, vision, general well-being and overall satisfaction were noted as significant improvements after COC use in women (p<.05), and the largest improvements were in physical health and living situation; all item scores except for work/school/labor, household activities and leisure time activities had improved statistically from baseline in YCu220 IUD users (p<.05). For COC users, the proportions of women with total quality-of-life scores ≥57 before and after COC use were 11.50% and 11.79%, respectively; but the proportion of YCu220 IUD users with total quality-of-life scores ≥57 increased from 4.40% to 12.04%. Compared to women without contraceptive use history, women with past OC and/or IUD use had a significantly higher difference in the total quality-of-life scores. Conclusions: COC and YCu220 IUD could significantly improve overall quality of life in rural women of the Jiangsu province. [Copyright &y& Elsevier]