进展期远端胃癌患者第12组淋巴结转移的影响因素及预后研究

Study on factors for metastasis in group 12 lymph nodes and prognosis of patients with advanced distal gastric cancer

目的探讨进展期远端胃癌患者第12组淋巴结转移的影响因素研究及预后。方法选择胃癌根治术患者共264例,按是否发生第12组淋巴结转移分为阴性组(228例)与阳性组(36例)。分析第12组淋巴结转移的影响因素及预后。结果单因素研究发现两组肿瘤直径、淋巴结转移的N和M分期、Bormann分期、第12组以外淋巴结转移情况存在显著差异。多因素研究发现,第12组以外淋巴结是否转移、肿瘤直径、远处转移M分期是第12组淋巴结转移阳性的独立危险因素。阳性组1年和2年生存率为57.2%和32.3%,阴性组1年和2年生存率为76.5%和58.9%,阳性组生存率显著低于阴性组。结论第12组淋巴结转移是进展期远端胃癌患者预后的重要影响因素,对肿瘤直径≥5cm或存在第12组以外淋巴结转移或远处转移的患者应考虑彻底清扫第12组淋巴结。

Objective To explore the factors for metaastasis in group 12 lymph nodes and prognosis of patients with advanced distal gastric cancer. Methods The clinical data of 264 patients undertaken gastrectomy were collected,and all these patients were divided into negative group（ 228 cases） and positive group（ 36 cases） according to the metastasis in group 12 lymph nodes. Factors for metastasis in group 12 lymph nodes were analyzed and the prognosis of patients was followed- up. Results Univariate analysis found that tumor size,metastasis in lymph nodes with N and M staging,Bormann staging,whether metastasis in lymph nodes beside group 12 had significant difference between these two groups. Multivariate analysis found whether metastasis of lymph nodes outspreaded to the outside of group 12,tumor size,M metastasis were the independent risk factors for metastasis in group 12 lymph nodes. One- year and 2- year survival rates of patients in positive group were 57. 2% and 32. 3% respectively,and those in negative group were 76. 5% and 58. 9% respectively,survival rate in positive group was significantly lower than that of negative group. Conclusion Metastasis in group 12 lymph nodes was an important factor for influencing prognosis of patients with advanced gastric cancer. In patients with the diameter of tumor ≥5 cm or metastasis in lymph nodes spread out than group 12 and with distant metastasis,thoroughly clean up group 12 lymph nodes should be considered.