腹腔脂肪量与胃癌病人术中淋巴结清扫的关系

Relationship between the intra-abdominal fat and lymphadenectomy in patients with gastric cancer

目的:探讨腹腔脂肪分布的CT测量与胃癌病人术中淋巴结清扫的关系。方法:回顾性收集2008年5月至2009年9月在我院外科胃切除加D2淋巴结清扫术的226例胃癌病人。手术前通过CT扫描及重建分别测量了腹腔脂肪面积(IFA)及腹腔脂肪体积(IFV)。将IFA分为高IFA组(IFA≥85 cm2)和低IFA组(IFA<85 cm2)两组;IFV分为高IFV组(IFV≥3 000 mL)和低IFV组(IFV<3 000 mL)两组。分别记录病人手术时间、术后胃周淋巴结剥出数,并进行组间比较。结果:大IFA、小IFA两组病人在中位淋巴结检出数分别方面存在明显的统计学差异(P<0.001)。结论:病人腹腔脂肪面积影响胃癌的术中淋巴结清扫个数。

Objective To explore the influence of intra-abdominal fat on the numbers of lymph nodes retrieved from patients with gastric cancer. Methods A total of 226 consecutive gastric cancer patients who underwent curative gastrcctomy from May 2008 to Sep 2009 were included in the study. Intra-abdominal fat area （IFA） and intra-abdominal volume （IFV） were measured pre-operation by CT scanning. The patients were classified into high IFA group （IFA ≥ 85 cm2） and low IFA group （IFA〈85 cm2） according to IFA. They were also classified into high IFV group （IFV≥ 3 000 mL） and low IFV group （IFV〈3 000 mL） according to IFV. Parameters such as time of operation, the numbers of lymph nodes retrieved were recorded and compared between groups. Results The numbers of lymph nodes retrieved were significantly different between high IFA group and low IFA group （P〈O.01）. Conclusions Our study reveals that IFA is associated with the numbers of lymph nodes retrieved for patients with gastric cancer.