进展期胃癌的淋巴结转移规律初探

A primary research on the regularity of lymph node metastasis in advanced gastric carcinoma

目的分析进展期胃癌的淋巴结转移规律，为其淋巴结切除范围提供参考依据。方法选择2013年5月一2013年8月行根治性切除手术的进展期胃癌36例，记录每例患者的淋巴结数目，计算淋巴结总数和平均值，计算总体淋巴结转移率以及分组淋巴结转移率。结果36例手术标本共检出淋巴结1401枚（16～107枚／例），平均（38．92±21．56）枚／例。36例中，淋巴结转移26例，总体淋巴结转移率为72％；其中，Nos．8p和Nos．12p淋巴结转移率分别为14％和11％。远端胃D2切除组淋巴结转移率为67％，Nos．1淋巴结无转移（0），Nos．3～9和Nos．11～12淋巴结转移率为8％～42％；全胃D2切除组淋巴结转移率为83％，Nos．1～11淋巴结转移率为17％～58％，Nos．12淋巴结转移率为8％（1／12）。结论进展期胃癌的淋巴结转移有明显规律，有助于指导淋巴结切除范围。

Objective To investigate the regularity of lymph node metastasis in advanced gastric carcinoma, in order to guide the extent of lymphadeneetomy. Methods The clinicopathological data of 36 patients with advanced gastric carcinoma who underwent radical surgery in our hospital from May 2013 to August 2013 were retrospectively analyzed. The nuinber of detected lymph nodes was recorded. The sum and the average number of detected lymph nodes, the total and sectionalized ratio of lymph node metastasis were calculated. Results A total of 1 401 （ 16- 107 ） lymph nodes were detected form the surgical specimens of 36 patients with advanced gastric carcinoma, and the average number of detected lymph nodes was 38.92 ±21.56. The total ratio of lymph node metastasis was 72%, the ratio of Nos. 8p and Nos. 12p were 14% and 11% respectively. The metastasis rate of patients underwent I）2 distal gastrectomy was 67%, the metastasis rate of Nos. 3-9 and Nos. 11-12 was 8%-42%, but Nos. 1 lymph nodes without metastasis. The metastasis rate of patients underwent D2 total gastrectomy was 83%, the metastasis rate of Nos. 1-11 and Nos. 12 were 17%-58% and 8% （1/12） respectively. Conclusions The metastasis of lymph node in advanced gastric carcinoma has certain regularity, which can provide a significant guidance for the extent of lymphadenectomy.