胃癌的淋巴结转移与清扫范围关系的探讨

The relationship between lymph node metastasis and the scope of lymphadenectomy in gastric cancer

目的:探讨胃癌淋巴结转移的特点及其对手术清扫范围的指导意义。方法:收集我院经手术治疗的103例胃癌患者的临床及病理资料,统计资料中淋巴结转移情况并计算淋巴结转移率,分析淋巴结转移率与肿瘤大小、临床分期、Borrmann分型的关系。结果:103例患者胃癌淋巴结转移率为68.9%(71/103)。随着肿瘤直径的增加,淋巴结转移率(度)也增高(P<0.05);临床分期中,胃癌的淋巴结转移率(度)随着临床分期的进展而增高,Ⅰ期患者淋巴结转移率(度)均低于其它期(P<0.01);Borrmann分型中,Ⅲ型患者的淋巴结转移率为81.6%(40/49),高于其它型(P<0.05),而Ⅳ型患者淋巴结转移度32.4%(161/497)最高。结论:淋巴结转移率和转移度随着胃癌的临床进展而增高。合理行扩大淋巴结清扫术能够及时清除肿瘤可能的转移灶,进而有助于降低患者肿瘤转移的可能性。

Objective：To investigate the characteristics of lymph nodes metastasis in gastric cancer and its guidance significance for the scope of lymphadenectomy.Methods： The clinicopathological data were collected in 103 patients with gastric cancer who underwented radical gastrectomy.Then the information of lymph node metastasis were collected and the lymph node metastasis rate were calculated.The relationship between lymph node metastasis rates and tumor diameters,clinical classification and Borrmann type were analyzed.Results： Among 103 patients with gastric cancer,lymph node metastases were 68.9%（71/103）.With the increase of tumor diameter,lymph node metastasis rate and degree was also increased（P0.05）.In clinical classification,the rate and degree of lymph node metastasis was elevated with clinical classification advancement of gastric cancer and they were significicantly lower in stageⅠthan in other stage（P0.01）.In Borrmann type,lymph nodes metastasis in gastric cancer among patients in Borrmann type Ⅲ 81.6%（40/49） was higher than other Borrmann types（P0.05）,while the degree of lymph node metastasis was highest in Borrmann type Ⅳ 32.4%（161/497）.Conclusion： The rate and degree of lymph node metastasis was elevated with clinical advancement of gastric cancer.A reasonable lymph node dissection might be timely removal of tumor metastases.Then it could help the patients with gastric cancer reduce possibility of distant metastasis.