胃癌浸润深度及组织学类型与淋巴结转移的关系

Relationship of infiltration depth and histological type with lymph node metastasis in gastric cancer

目的探讨胃癌浸润深度及组织学类型与淋巴结转移的关系，为临床进行合理的淋巴结清扫范围提供依据。方法回顾性分析1994年6月至1998年1月行根治性切除手术的268例胃癌患者的病理资料，统计胃癌浸润深度及组织学类型与淋巴结转移之间的关系。结果胃癌浸润深度在T1、T2、T3和T3时的淋巴结转移率分别为4．6％、53．1％、78．7％和100％，依次呈递增趋势（P〈0．01）。未分化癌、黏液腺癌、低分化腺癌、分化型腺癌和印戒细胞癌的淋巴结转移率分别为100％、66．7％、77．8％、48．8％和33．3％（P〈0．01）。N0、N1、N2和N3患者的5年生存率分别为84．3％、30．1％、9．1％和0，各组比较差异有统计学意义（P〈0．01）。结论胃癌的浸润深度及组织学类型与淋巴结转移相关，而淋巴结转移情况与患者的5年生存率密切相关。

Objective To investigate the relationship of infiltration depth and histological type with lymph node metastasis in gastric cancer so as to offer basis for dissecting appropriate extent of the lymph node. Methods A retrospective analysis was done on 268 cases with gastric cancer undergone curative gastrectomy from June 1994 to January 1998 to study relationship of filtration depth and histological type with lymph node metastasis. Results The lymph node metastasis rates at infiltrative depths of T1, T2, T3 and T4 cases were 4.6%, 53.1%, 78.7% and 100% respectively, with statistically significant difference （ P 〈0.01 ）. The lymph node metastasis rates in undifferentiation, mucoid carcinoma, differentiation, well-differentiation and signet ring carcinoma were 100%, 66.7%, 77.8%, 48.8% and 33.3% respectively, with statistically significant difference （ P 〈0.01 ）. The 5-year survival rates in NO, N1, N2 and N3 were 84.3% , 30.1% , 9.1% and 0 respectively, with statistically significant difference （ P 〈 0.01 ）. Conclusions The infiltration depth and histological type of gastric cancer are correlated with the lymph node metastasis, the status of which is related to 5-year survival rate of cases.