胃周阳性淋巴结数目是胃癌的一个预后指标

Number of Positive Perigastric Lymph Nodes as a Prognostic Indicator in Gastric Cancer

目的：研究胃周阳性淋巴结数目在胃癌预后中的意义。方法：将１２４例经组织学证实为淋巴结阳性者作为研究对象，分析胃周转移淋巴结数目与临床病理特征及生存率的关系。结果：１２４例胃周淋巴结阳性胃癌患者总的５年生存率为４８．３％，胃周阳性淋巴结超过６个的患者５年生存率明显下降（Ｐ＜０．０１）。与胃周阳性淋巴结≥７个的胃癌相比，阳性淋巴结数≤６个的胃癌常小于４ＣＣ（Ｐ＜０．００５），多呈大体局限型（Ｐ＜０．０２５），未侵及浆膜（Ｐ＜０．０１），巨淋巴结转移多局限于胃周淋巴结（Ｐ＜０．００５）。结论：胃周阳性淋巴结数目与肿瘤进展和生存率相关，是淋巴结阳性胃癌的一个简便有用的预后指标。

Objective: To evaluate the prognostic significance of the number of positive perigastric lymph nodes in patients with gastric cancer. Methods: Between 1987 and 1994, 124 cases of node-positive gastric cancer treated by radical gastrectomy and lymph node dissection(D2 or D3) were studied The perigastric and regional lymph nodes were examined histologically and the influence of the number of positive nodes on the survival rate was analyzed Results: The overall 5-year survival rate of the series was 48.3%; The 5-year survival rate decreased significantly when the number of positive nodes exceeded 6(55% for 1 -6 nodes vs 26% for ≥ 7 nodes, P< 0.01). Cases with 1 to 6 positive nodes were more likely to have a diameter of gstric cancer less than 4cm(P<0.005); the gastric cancer tended to belong to the grossly localized type(P<0.025), to have no serosal invasion(P<0.01) and to have metastasis limited to the perigastric lymph nodes(P<0.005). Conclusions: The number of positive perigastric and regional lymph nodes is a simple and useful prognostic indicator for gastric cancer.