摘要
目的 探讨贲门癌外科切除淋巴结清扫范围及其意义。方法 回顾性随机分析手术切除贲门癌217例。淋巴结清扫范围按D0～D4分级;手术根治程度按A、B、C三级标准进行分级。结果 全组近端胃＋食管下段切除186例,全胃＋食管下段切除31例;联合脏器切除97例。D1级手术150例,D2级手术58例,D3级手术1例;A级手术53例,B级手术107例,C级手术57例。全组有淋巴结清扫记录210例,有淋巴结转移157例,转移率72.4%,其中1、2、3、4、7、9、10、11、110组及下肺韧带淋巴结转移率为高;全组共清扫淋巴结2868枚,阳性655枚,总转移度为22.8%,其中1、2、3、4、7、9、12、110组及下肺韧带组淋巴结转移度为高。结论 全组D1级手术治疗的患者与D2级手术治疗的患者生存率相似;Ⅲa期D1级手术治疗的患者与D2级手术治疗的患者2、3年生存率有一定的差异,Ⅲb期D2级手术治疗的患者生存率优于D1级手术治疗的患者;Ⅳ期D1级手术治疗的患者生存率优于D2级手术治疗的患者。A、B级手术的患者生存率明显高于C级;A级手术后患者生存率也高于B级。
Objective To Study the extent and value of the elimination of lymph nodes in surgical treatment for carcinoma of gastric cardia. Methods The data of 217 patients receing gastrectomy for carcinoma of gastric cardia were retrospectively randomized. The extent of lymphadenectomy was divided into five （ DO to D4） and the degree of radical cure was graded as A, B and C. Results A total of 186 patients were treated with partial gastrectomy and esophagectomy ,31 with total gastrectomy and 97 with combined devisceration. The patients who underwent D1 ,D2 and D3 lymphadenectomy were 150,58 and 1 respectively. The patients who were performed with the resection of grade A, B and C was 53,107 and 57 respectively. Of the 210 patients, the lymphatic metastasis occurred in 157（72.4% ）. The lymphatic metastasis rate in the group 1,2,3,4,7,9,12 and 110 as well as in the pulmonary ligament group were at top level compared to other groups. Of the 2868 lymph nodes removed ,655 （ 22.8% ） demonstrated the existence of metastasis. The total metastatic degree of lymph nodes in these groups was higher compared to the other groups. Conclusion The survival rate in the D1 and D2 is similar,and there may be some differences in the 2nd and 3rd years for the D1 and D2 in the stage- Ⅲ b patients. The survival rate of D2 in stage Ⅲ b is better than D1 and that of D2 is superior to D1 in stage-Ⅳ patients. The survival rate of grade A and B in operation is much better than grade C, and grade A is also superior to B.
出处
《实用癌症杂志》
2007年第2期185-187,190,共4页
The Practical Journal of Cancer
关键词
贲门癌
外科切除
淋巴结
范围
Carcinoma of gastric cardia, Surgical resection, Lymph node, Extent of elimination
