摘要
目的:探讨进展期胃癌淋巴结转移与临床病理特征的关系,为临床上进行合理的淋巴结清扫提供依据。方法:对55例进展期胃癌资料进行回顾性分析,术后常规解剖原发灶及各组淋巴结,并标记和计数,分析肿瘤部位、肿瘤大小、浸润深度、分化程度及Lauren分型与淋巴结转移率的关系。结果:进展期胃癌淋巴结转移率为74.5%;U、M、L区及全胃癌淋巴结转移率为85.7%、87.5%、67.6%和83.3%,各区和全胃癌淋巴结转移率差异无统计学意义(P>0.05);浆膜受侵的胃癌淋巴结转移率为82.5%,明显高于浆膜未受侵者(53.3%)(P< 0.05);弥漫型胃癌淋巴结转移率为83.3%,明显高于肠型(64.0%)(P<0.05);直径>5 cm癌灶淋巴结转移率为90.0%,明显高于直径≤5 cm的胃癌患者(65.7%)(P<0.05);浸润深度、Lauren分型和肿瘤大小是影响淋巴结转移率的主要因素,其中浸润深度为独立影响因素。结论:术中淋巴结清扫范围应结合肿瘤部位、肿瘤大小、浸润深度、分化程度及Lauren分型做出判断,并考虑患者的全身情况,合理选择淋巴结清扫范围。
Objective： To investigate the relationship between clinicopathological features and lymph node metastasis（LNM） in the advanced gastric cancer and offer the basis for deciding appropriate extent of lymph node dissection. Methods： Firty-five patients who underwent curative gastrectomy and lymph node dissection for gastric cancer were analyzed retrospectively. Results： The total rate of LNM was 74.5%. The LNM of U, M, L region and the whole stomach were 85.7, 87.5%, 67.6% and 83.3%, respectively （P〉0.05）. The rate of LNM of serosa invasion （82.5%）were significantly higher than that of no invasion（53.3%） （P〈0.05）. The metastasis rate of the diffuse type（83.3%）was higher than that of the intestinal type（64.0%） （P〈0.05）., The metastasis rate of 〉5 cm（90.0%）was more than ≤5 cm （65.7%） （P〈0.05）. Lauren classification, tumor depth and tumor size were main factors to influence the rate of LNM and tumor depth was independent factor. Conclusions. The study suggests the appropriate extent of lymph node dissection should be done during the operation on the basis of clinicopathological features of gastric cancer along with the state of LNM in cancer of different region of the stomach and the general condition of patients.
出处
《新疆医科大学学报》
CAS
2005年第11期1025-1028,共4页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区教育厅高校科研计划重点项目(XJEDU2004134)
关键词
胃癌
淋巴结转移
病理特征
gastric cancer
lymph node metastasis
pathological features
