肠系膜上静脉14v组淋巴结清扫在胃癌淋巴结转移中的临床意义

Clinical significance of dissection of superior mesenteric vein 14v group lymph node in gastric cancer metastasis

目的研究清扫胃癌患者第14v组淋巴结,并分析其转移情况,探讨14v组淋巴结转移的影响因素及对预后的影响。方法回顾性分析2004年3月至2012年3月120例接受胃癌根治术清扫14v组淋巴结的患者资料。结果胃下部癌患者检出176枚14v组淋巴结,29枚发生转移;TNM分期Ⅳ期5例、ⅢC期7例发生14v组淋巴结转移,转移率分别为50.0%、33.3%;BorrmannⅣ型4例、Ⅲ型11例发生14v组淋巴结转移,转移率分别为80.0%、30.6%,高于Ⅰ、Ⅱ型病例(P<0.05)。发生14v组淋巴结转移病例中15例侵透浆膜(83.3%),侵犯周围器官。14v组淋巴结转移患者5年生存率为7.7%。结论肿瘤位置、分期、Borrmann分型、侵犯周围组织与第l4v组淋巴结的转移有一定关系;分期较晚患者行14v组淋巴结清扫难以获得较满意的预后。

Objective Through investigate dissection of 14v group lymph node of patients with gastric cancer and its metastasis , to explore the influence factors and prognosis of dissection of 14v group lymph node .Methods 120 cases of gastric cancer patients who underwent radical gastrectomy and dissected 14v group lymph node since Mar .2004 to Mar .2012 were analyzed ,through his-topathological and immunohistochemical examination to detect the 14v group lymph node metastasis and calculation .Results Gas-tric antrum carcinoma were detected 176 nodes ,29 nodes were metastasis ,but there were none in other places .About TNM classifi-cation ,14v group lymph node metastasis among patients in stage Ⅳ（5 cases） was 50 .0% ,in stage ⅢC（7 cases）was 33 .3% ;About Borrmann classification ,14v group lymph node metastasis among patients in borrmann type Ⅳ （4cases） was 80 .0% ,in stage Ⅲ（11cases） was 30 .6% ,which were higher than that of other types（P〈0 .05） .Among the 18 cases which had 14v group lymph node metastasis ,15 cases（83 .3% ）invaded serosa ,invading the surrounding organs .The 5 year rate of 14v group metastasis patients was 7 .7% .Conclusion Gastric carcinoma tumor size ,tumor stage ,Borrmann classification ,invading the surrounding organs and tissues and metastasis in 14v group lymph node have a certain relationship .14v lymph node dissection for lately TNM stage gastric tumor has no certain significance .