胃癌不同部位淋巴结转移率及其临床意义的研究

Primary Study on Anatomical Extent of Lymph Node Metastases in Gastric Cancer and Its Significance in Surgical Treatment

目的探讨胃癌不同部位淋巴结转移的分布特点,旨在为合理的外科治疗提供依据。方法回顾性分析1995年1月至2004年12月期间在中国医科大学附属第一医院胃肠肿瘤外科实施手术的胃癌病例,分析各组淋巴结的转移率及其特点。结果 1 505例胃癌患者中,928例出现淋巴结转移,转移率为61.7%。上部癌(U)中转移率较高的淋巴结依次是No.1(32.9%)、No.3(28.7%)、No.2(20.4%)及No.7(18.6%);中部癌(M)中转移率较高的淋巴结依次是No.3(32.5%)、No.4(24.7%)、No.7(20.6%)及No.1(17.3%);下部癌(L)中转移率较高的淋巴结依次是No.6(33.7%)、No.3(31.3%)、No.4(25.6%)及No.7(21.5%)。结论胃周淋巴结转移根据胃癌的部位、浸润深度等,有着不同的特点。了解胃周淋巴结的转移规律能够获得pN分期无法提供的信息,对于正确评估胃癌的淋巴结转移程度、制订治疗方案及手术范围,具有重要的意义。

Objective To evaluate the status of lymph node metastasis and reasonable procedure in gastric cancer.Methods The incidence of metastases from gastric cancer to various regional lymph node stations was studied in 1 505 patients with gastric cancer.The patients underwent surgical resection from January 1995 to December 2004.Results Lymph node metastasis were observed in 928 of 1 505 cases（61.7%）.Lymph node metastasis frequency was found in groups No.1（32.9%）,No.3（28.7%）,No.2（20.4%）,and No.7（18.6%） at upper third stomach cancer;in groups No.3（32.5%）,No.4（24.7%）,No.7（20.6%）,and No.1（17.3%） at middle third stomach cancer;in groups No.6（33.7%）,No.3（31.3%）,No.4（25.6%）,and No.7（21.5%） at lower third stomach cancer.Conclusions Distribution of metastatic lymph node is clearly related to the location of the tumor.Anatomical extent of lymph node metastases in gastric cancer provid surgical guidance for surgeons.