深度分析胃癌手术中淋巴结清扫方式对远期效果的影响

In-depth Analysis of the Effect of Lymph Node Dissection on Long-term Results in Gastric Cancer Surgery

目的研究可切除进展期胃癌进行D2+No.8p淋巴结清扫对比单纯D2淋巴结清扫的优势价值。方法选取2017年1月-2019年1月就诊于我院的可切除进展期胃癌130例,其中D2+8p组70例,D2组60例。对比两组一般临床资料、术中相关资料、术后病理资料,评估两组资料选择的一致性,然后对两组治疗的生存数据进行统计,分析D2+8p淋巴结清扫对于可切除进展期胃癌的远期优势。结果两组术前资料比较显示,患者年龄、性别、肿瘤位置、肿瘤大小、术前肿瘤标志物CEA、CA724、CA199比较,差异无统计学意义(P>0.05);D2+8p组的手术时间长于D2组(P<0.05),但两者住院时间比较,差异无统计学意义(P>0.05)。两组患者术后病理学资料中T分期、N分期、AJCC分期、组织学分化程度、Lauren分型比较,差异无统计学意义(P>0.05);D2+8p组的淋巴结检出数量和阳性淋巴结数量都多于D2组(P<0.05);经过3年6个月随访,D2+8p组生存时间长于D2组(P<0.05)。结论D2+8p清扫对于可切除进展期胃癌的远期生存具有明显价值。

Objective To study the value of D2+No.8p lymph node dissection in resectable advanced gastric cancer that compared with D2 lymph node dissection alone.Methods A total of 130 cases of resectable advanced gastric cancer treated in our hospital from January 2017 to January 2019 were selected,including 70 cases in the D2+8p group and 60 cases in the D2 group.The general clinical data,intraoperative related data and postoperative pathological data of the two groups were compared to evaluate the consistency of data selection between the two groups.Then the survival data of the two groups were statistically analyzed to analyze the long-term advantages of D2+8p lymph node dissection for resectable advanced gastric cancer.Results The comparison of preoperative data between the two groups showed that there were no significant difference in age,gender,tumor location,tumor size,preoperative tumor markers CEA,CA724 and CA199 between the two groups(P>0.05).The operation time of the D2+8p group was longer than that of the D2 group(P<0.05),but there was no significant difference in hospitalization time between the two groups(P>0.05).There were no significant difference in T stage,N stage,AJCC stage,histological differentiation and Lauren classification between the two groups(P>0.05).The number of lymph nodes detected and the number of positive lymph nodes in the D2+8p group were more than those in the D2 group(P<0.05).After 3 years and 6 months of follow-up,the survival time of the D2+8p group was longer than that of the D2 group(P<0.05).Conclusion D2+8p dissection has significant value for the long-term survival of resectable advanced gastric cancer.