摘要
目的:分析进展期近端胃癌的淋巴结转移规律,为进展期近端胃癌的胃切除范围以及是否需要联合切脾提供参考依据.方法:选择江汉大学附属医院1989-01/2010-09行根治性切除手术的进展期近端胃癌86例,记录每例患者的淋巴结数目和大小,计算淋巴结总数和平均值,计算总体淋巴结转移率以及No.1-16淋巴结转移率.结果:86例手术标本共检出淋巴结4756枚(30-157枚),平均55.30±20.23枚/例.其中≤5mm的淋巴结占81.14%(3859/4756).86例中70例有淋巴结转移,淋巴结转移率81.40%.有癌转移的淋巴结中,≤5mm的淋巴结占60.96%(556/912).总体淋巴结转移率为81.40%.No.1-4和No.7-9淋巴结转移率较高(39.53%-80.23%),而No.12-15淋巴结转移率极低(0.00%-2.33%),No.16淋巴结转移率为15.12%.No.5和No.6淋巴结转移率分别为22.09%和15.12%.No.10和No.11淋巴结转移率分别为33.2%和18.60%.结论:进展期近端胃癌的淋巴结转移规律有助于指导淋巴结切除术,因为切除No.5-6和No.10-11淋巴结的需要,进展期近端胃癌宜行全胃切除联合脾切除术.
AIM： To investigate the pattern of lymph node metastasis in advanced proximal gastric cancer to guide the extent of stomach resection （proximal or total gastrectomy） and to evaluate the necessity of splenectomy.METHODS： The clinicopathological data for 86 patients with advanced proximal gastric cancer who underwent radical gastrectomy at our hospital from January 1989 to September 2010 were retrospectively analyzed. The number and size of detected lymph nodes were recorded. Thetotal and average number of detected lymph nodes, total rate of lymph node metastasis, and metastasis rates of Nos. 1-16 lymph nodes were calculated.RESULTS： A total of 4 756 （30-157） lymph nodes were detected in the surgical specimens from 86 patients with advanced proximal gastric cancer, and the average number of detected lymph nodes was 55.30 ± 20.23. Of 4 756 detected lymph nodes, 3 859 （81.14%） had a size of ≤5 mm. Seventy of 86 cases had lymph node metastasis, and the total rate of lymph node metastasis was 81.40%. Of 912 metastatic lymph nodes, 556 （60.96%） had a size of ≤5 mm. The metastasis rates of Nos. 1-4 and 7-9 lymph nodes （39.53%-80.23%） were higher than those of Nos. 12-15 （0.00%-2.33%）. The metastasis rates of Nos 5, 6, 10, 11 and 16 lymph nodes were 22.09%, 15.12%, 33.72%, 18.60% and 15.12%, respectively.CONCLUSION： Analysis of the pattern of lymph node metastasis in proximal advanced gastric cancer has an appreciable value in guid-ing lymphadenectomy. Total gastrectomy plus splenectomy is a feasible radical surgery for proximal advanced gastric cancer because of the requirement of resection of Nos. 5-6 and Nos. 10-11 lymph nodes.
出处
《世界华人消化杂志》
CAS
北大核心
2011年第12期1300-1306,共7页
World Chinese Journal of Digestology
关键词
近端胃癌
淋巴结转移
淋巴结切除术
胃切除术
脾切除术
Proximal gastric cancer
Lymph node metastasis
Lymphadenectomy
Gastrectomy
Splenectomy
