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目的探讨Vater壶腹及乳头癌的淋巴结转移特点及相关影响因素。方法回顾性分析152例Vater壶腹及乳头癌患者根治术后的淋巴结转移特点,分析其临床病理相关影响因素。结果对152例Vater壶腹及乳头癌行根治性胰十二指肠切除术,淋巴结转移率为31％,其中T1、T2、T3、T4期淋巴结转移率分别为0、20％(11／54)、26％(19／72)及94％(16／17)。淋巴结转移相关因素有:肿瘤直径(<3 cm与≥3 cm相比,P=0．002)、肿瘤分化程度(P=0．012)、十二指肠壁浸润(P= 0．008)、T分期(P=0．000)及胰腺受侵(P=0．005)。结论Vater壶腹及乳头癌淋巴结转移率高;根治性手术切除是主要的治疗方式;行肿瘤局部切除时应选择适合的病例。
Objective To investigate the lymph node metastasis of Vater ampulla and papillary carcinoma and its related factors. Methods A retrospective analysis of 152 cases of Vater ampulla and papillary carcinoma in patients with radical lymph node metastasis characteristics of its clinical and pathological factors related to analysis. Results 152 cases of Vater ampulla and papillary carcinoma underwent radical pancreaticoduodenectomy. The rate of lymph node metastasis was 31%. The rates of lymph node metastasis in T1, T2, T3 and T4 were 0,20% (11/54 ), 26% (19/72) and 94% (16/17). The related factors of lymph node metastasis were tumor diameter (P = 0.002), tumor differentiation (P = 0.012), infiltration of duodenal wall (P = 0.008) , T stage (P = 0.000) and pancreas invasion (P = 0.005). Conclusion Vater ampulla and papillary carcinoma of the lymph node metastasis rate is high; radical surgical resection is the main treatment; tumor resection should choose the appropriate cases.