贲门癌淋巴结转移的临床病理特点及意义

A Retrospect of the Clinical Pathology of Lymphonode Metastasis in Cardia Carcinoma:Characteristic and Significance

背景:贲门癌是位于食管胃结合部的消化道肿瘤,淋巴结转移有向胸腹腔两个途径转移,淋巴结转移是制约贲门癌长期生存的最重要因素。患者与方法:总计100例患者,其中男性80例,女性20例,年龄29~75岁,平均年龄57.8岁,均经病理确诊为贲门腺癌,所有病例均完成手术治疗。其中经左胸76例、经腹22例,胸腹联合切口2例。手术发现肿瘤<3.0 cm 8例,3.0 cm^7.0 cm 68例,>7 cm 24例。结果:淋巴结转移与肿瘤大小的关系不大,但与肿瘤侵及深度关系密切。手术方式对淋巴结转移的贲门癌是一种有效方式,可以给患者带来长期生存获益。统计学处理采用卡方检验进行统计学处理来研究淋巴结转移与临床预后的关系。结论:手术方式对淋巴结转移的贲门癌是一种有效治疗方式,可以给患者带来长期生存获益。探索一种创伤小,安全性高的贲门癌外科手术治疗标准术式势在必行,经上腹左胸二切口贲门癌切除二野淋巴结清扫术是理想术式。

Background:Cardia carcinoma,a digestive cancer located between oesophagus and gastric,its way of lymphonode metastasis could be thorax or/and celiac.Lymphonode metastasis impact long term survival of these patients.Patients and Methods:To retrospect 100 patients have been enrolled with pathology confirmed Cardia adenocarcinoma:male(n=80),female(n=20),all post resection.Median patient age was 57.8 years(range 29～75).Resection via left thorax(n=76),via abdomen(n=22),via thorax-celiac coalesce(n=2);tumor dia.&...