胃癌14v组淋巴结转移的危险因素及转移对患者预后的影响分析

Risk Factors of 14V Lymph Node Metastasis in Gastric Carcinoma and Effect of Metastasis on the Prognosis

目的探讨胃癌14v组淋巴结转移的危险因素及转移对患者预后的影响。方法对93例行胃癌根治术治疗的胃癌患者的临床资料进行回顾性分析,观察其14v组淋巴结转移情况,分析影响因素;并将其分为转移组及非转移组,对比2组患者的预后。结果 93例患者共出现13例14v组淋巴结转移,转移率13.98%。单因素回归分析发现,胃癌14v组淋巴结转移与病灶位置、肿瘤Borrmann分型、淋巴结转移数量及TNM分期有关(P<0.05),与年龄、性别、病灶直径、分化程度及浸润深度方面无关(P>0.05);多因素回归分析发现,胃下部肿瘤、Borrmann分型Ⅲ~Ⅳ型、淋巴结转移数量N3及肿瘤TNM分期Ⅲ~Ⅳ期均为影响胃癌14v组淋巴结转移的独立危险因素(P<0.05)。与非转移组相比,转移组病死率更高,中位生存时间更短(P均<0.05)。结论具有上述指标的患者具有更高的14v组淋巴结转移风险,在术前应明确患者的各项指标,制定相应的淋巴结清扫范围,在确保患者的淋巴屏障功能得到有效保护的前提下尽可能清除癌灶,保证其预后及生存质量。

Objective To investigate the risk factors of 14 v lymph node metastasis in gastric carcinoma and effect of metastasis on the prognosis,and provide method to improve the prognosis of the patients. Methods Clinical data of 93 patients with gastric cancer treated with radical operation were retrospectively analyzed,and 14 v lymph node metastasis were observed and divided into metastasis group and non-metastasis group,the clinical data were compared between the 2 groups,factors affecting the prognosis were analyzed and prognosis were compared between the 2 groups. Results In 93 patients,there were 13 cases of 14 v lymph node metastasis,distant metastasis rate was 13. 98%. Single factor regression analysis showed that 2 groups of patients in the location of the lesion,tumor Borrmann type,lymph node metastasis and TNM staging was statistically significant( P < 0. 05),in age,gender,tumor size,differentiation and infiltration depth difference was not statistically significant( P > 0. 05); multi-factor regression analysis found that the lower part of the stomach,tumor,Borrmann type Ⅲ ~ Ⅳ type,lymph node metastasis in N3 and tumor TNM stage Ⅲ ~ Ⅳ were the independent risk factors for metastasis of gastric cancer 14 v lymph node( P < 0. 05). Conclusion Patients with the above indexes has higher risk of 14 v lymph node metastasis,and all indexes should be clear before surgery to formulate corresponding lymph node dissection area. The lymph barrier function of patients can be effectively protected by remove the tumor,and ensure the prognosis and quality of life.