BACKGROUND Radical gastrectomy with D2 lymph node (LN) dissection is the standard surgical procedure for patients with resectable gastric cancer (GC). In the fifteenth edition of the Japanese Classification of Gastric...BACKGROUND Radical gastrectomy with D2 lymph node (LN) dissection is the standard surgical procedure for patients with resectable gastric cancer (GC). In the fifteenth edition of the Japanese Classification of Gastric Carcinoma, the 14v LN (LNs along the root of the superior mesenteric vein) was defined as the regional gastric LN. The efficacy of 14v LN dissection during radical distal gastrectomy for lower-third GC remains controversial. AIM To analyze whether the addition of 14v LN dissection improved the survival of patients with lower-third GC. METHODS The data from 65 patients who underwent 14v LN dissection and 65 patients treated without 14v LN dissection were selected using the propensity scorematched method from our institute database constructed between 2000 and 2012. Overall survival was compared between the groups. RESULTS Overall survival was similar between patients with 14v LN metastasis and those with distant metastasis (P = 0.521). Among patients with pathological stage IIIA disease, those who were treated with 14v LN dissection had a significantly higher overall survival than those treated without it (P = 0.020). Multivariate analysis showed that age < 65 years and pT2-3 stage were independent favorable prognostic factors for prolonged overall survival in patients with pathological stage IIIA disease. Patients with No. 1, No. 6, No. 8a, or No. 11p LN metastasis were at higher risk of having 14v LN metastasis.CONCLUSION Adding 14v LN dissection to D2 dissection during radical distal gastrectomy may improve the overall survival of patients with pathological stage IIIA lower-third GC.展开更多
目的研究可溶性白细胞分化抗原14（soluble cluster of differentiation antigen14，sCD14）与损伤严重程度评分（injuryseverityscore，ISS）对急诊多发伤患者预后的相关性及判断价值。方法选择北京朝阳医院急诊外科2009年10月至2010年...目的研究可溶性白细胞分化抗原14（soluble cluster of differentiation antigen14，sCD14）与损伤严重程度评分（injuryseverityscore，ISS）对急诊多发伤患者预后的相关性及判断价值。方法选择北京朝阳医院急诊外科2009年10月至2010年3月首次就诊并且住院治疗的多发伤患者86例作为多发伤组，随访28d预后分为存活组和死亡组，另选20名健康体检者作为健康对照组。检测多发伤组就诊24h内以及第3、5、7天和健康对照组血清sCD14质量浓度并进行APACHEII评分，并在急诊24h内进行损伤严重程度评分并且根据预后计算与sCD14的相关性，并利用ROC曲线判断sCD14与两种不同评分方法对多发伤患者死亡的预测价值。结果多发伤组患者入院后sCD14质量浓度进行性上升，各时间点质量浓度均明显高于健康对照组（P〈0．01）；死亡组sCD14质量浓度各个时间点明显高于存活组（P〈0．05）；多发伤组患者sCD14质量浓度与损伤严重度评分呈正相关（r=0．469，P〈0．01）；ROC曲线分析，sCD14与ISS评分在预测多发伤患者死亡风险程度上均具有预测价值，但二者曲线下面积（sCD14=0．820，ISS评分0．705）差异无统计学意义（P〉0．05）。结论多发伤患者sCD14质量浓度与ISS评分具有正相关性，对多发伤患者病情预后具有预测意义。展开更多
基金Supported by Foundation for Innovative Talents in Higher Education of Liaoning Province,No.LR2016043
文摘BACKGROUND Radical gastrectomy with D2 lymph node (LN) dissection is the standard surgical procedure for patients with resectable gastric cancer (GC). In the fifteenth edition of the Japanese Classification of Gastric Carcinoma, the 14v LN (LNs along the root of the superior mesenteric vein) was defined as the regional gastric LN. The efficacy of 14v LN dissection during radical distal gastrectomy for lower-third GC remains controversial. AIM To analyze whether the addition of 14v LN dissection improved the survival of patients with lower-third GC. METHODS The data from 65 patients who underwent 14v LN dissection and 65 patients treated without 14v LN dissection were selected using the propensity scorematched method from our institute database constructed between 2000 and 2012. Overall survival was compared between the groups. RESULTS Overall survival was similar between patients with 14v LN metastasis and those with distant metastasis (P = 0.521). Among patients with pathological stage IIIA disease, those who were treated with 14v LN dissection had a significantly higher overall survival than those treated without it (P = 0.020). Multivariate analysis showed that age < 65 years and pT2-3 stage were independent favorable prognostic factors for prolonged overall survival in patients with pathological stage IIIA disease. Patients with No. 1, No. 6, No. 8a, or No. 11p LN metastasis were at higher risk of having 14v LN metastasis.CONCLUSION Adding 14v LN dissection to D2 dissection during radical distal gastrectomy may improve the overall survival of patients with pathological stage IIIA lower-third GC.
文摘目的研究可溶性白细胞分化抗原14（soluble cluster of differentiation antigen14，sCD14）与损伤严重程度评分（injuryseverityscore，ISS）对急诊多发伤患者预后的相关性及判断价值。方法选择北京朝阳医院急诊外科2009年10月至2010年3月首次就诊并且住院治疗的多发伤患者86例作为多发伤组，随访28d预后分为存活组和死亡组，另选20名健康体检者作为健康对照组。检测多发伤组就诊24h内以及第3、5、7天和健康对照组血清sCD14质量浓度并进行APACHEII评分，并在急诊24h内进行损伤严重程度评分并且根据预后计算与sCD14的相关性，并利用ROC曲线判断sCD14与两种不同评分方法对多发伤患者死亡的预测价值。结果多发伤组患者入院后sCD14质量浓度进行性上升，各时间点质量浓度均明显高于健康对照组（P〈0．01）；死亡组sCD14质量浓度各个时间点明显高于存活组（P〈0．05）；多发伤组患者sCD14质量浓度与损伤严重度评分呈正相关（r=0．469，P〈0．01）；ROC曲线分析，sCD14与ISS评分在预测多发伤患者死亡风险程度上均具有预测价值，但二者曲线下面积（sCD14=0．820，ISS评分0．705）差异无统计学意义（P〉0．05）。结论多发伤患者sCD14质量浓度与ISS评分具有正相关性，对多发伤患者病情预后具有预测意义。
