早期胃癌淋巴结转移的临床病理学分析及其外科治疗

The clinicopathological features of lymphatic metastasis and surgical treatment of early gastric cancer

目的探讨早期胃癌（EGC）淋巴结转移的临床病理学特征。方法回顾性分析1990年10月至2000年10月外科手术切除294例EGC的临床及病理学资料。结果本组294例EGC[黏膜内癌（M癌）129例、黏膜下层癌（SM癌）165例]中，M癌、SM癌的淋巴结转移率分别为2．3％、18．2％。淋巴结转移与肿瘤浸润深度、组织学分类有明显的关系（P〈0．05），其中M癌淋巴结转移主要发生在未分化型癌（8．6％）及陷凹型癌（6．3％）中，而SM癌淋巴结转移与肿瘤大小、肉眼分型则无明显的关系。结论EGC淋巴结转移与肿瘤的浸润深度、组织学分型有明显的关系。对于EGC的手术要考虑癌灶的形态、分型、浸润深度以及淋巴结转移等因素。

Objective To analyze the clinicopathological features of lymphatic metastasis and surgical treatment of early gastric cancer （EGC）. Methods The clinicopathological data of 294 EGC cases from Oct 1990 to Oct 2000 undergoing resection were analyzed retrospectively. Results Lymph node metastasis was more common in patients with submucous （SM） cancer （18.2%） than in those with mucous （M） cancer （2. 3% ）. Lymph node metastasis was found in 7.4% cases of differentiated adenocarcinoma,in 18.8% cases of undifferentiated adenocarcinoma respectively. Metastasis was also associated with the depth of cancer invasion and histological type. Conclusions The lymphatic metastasis of EGC was closely related to the depth of cancer invasion and histological type, hence tumor size, histological type,depth of cancer invasion and lymphatic metastasis must be kept in mind when a surgical procedure is contemplated.