Objective   To analyze clinicopathological features of type 3 gastric neuroendocrine tumor (NET) without distant metastasis and identify risk factors of lymph node metastasis.

  Methods   Data of 36 patients with type 3 gastric NET without metastasis from March 2016 to May 2019 in China-Japan Friendship Hospital were retrospectively analyzed. A Logistic regression model was used to identify risk factors of lymph node metastasis.

  Results   This study included 36 patients, and eight patients (22.2%) had lymph node metastasis. Patients with lymph node metastasis had a larger tumor diameter and higher Ki-67 index than those without lymph node metastasis. In addition, endoscopic ulcerative lesions were more common (50%), and the T staging of the tumor was mainly T4 (50%). Univariate analysis revealed that tumor diameter ≥2 cm, ulcerative lesions, and pathological grade G2/3 and T2/4 were the main risk factors of lymph node metastasis. Multivariate analysis revealed that only tumor diameter ≥2 cm odds ratio (OR)=8.54; 95%CI: 1.16-62.96 and ulcerative lesions (OR) =10.97; 95%CI: 1.16- 103.52) were independent factors affecting lymph node metastasis.

  Conclusions   In patients with type 3 gastric NET with high risk factors for lymph node metastasis, it is necessary to comprehensively evaluate the regional lymph node status before surgery to select the best treatment.