论文部分内容阅读
目的 探讨胃癌孤立性淋巴结转移的规律及其临床价值。方法 分析49例孤立性胃癌淋巴结转移患者的临床病理资料,比较跳跃性转移与非跳跃性转移两组之间的临床病理及预后的差别。结果 本组孤立性淋巴结转移率为13 5%,跳跃性转移发生率为4 4%。非跳跃性转移组33例,以第3、6组常见;跳跃性转移组16例,以第7组常见。位于第二站者14例,位于第三站者2例(均为第12组)。与非跳跃式转移组相比,跳跃式转移与肿瘤浸润全层(χ2 =5 08,P=0 016)以及肿瘤大小(t=2 215,P=0 032 )均有显著相关性。两组复发率和生存率之间差异均无统计学意义。结论 胃癌孤立性淋巴结转移以胃周为主。跳跃式转移与肿瘤浸润全层及肿瘤大小有关,以胃左动脉周围淋巴结多见。D2 根治术加第12组淋巴结清扫有利于预防跳跃性转移灶的残留。
Objective To investigate the regularity and clinical value of isolated lymph node metastasis in gastric cancer. Methods The clinicopathological data of 49 patients with lymph node metastasis of isolated gastric cancer were analyzed. The differences of clinicopathological features and prognosis between the two groups were compared between skip metastasis and non-skip metastasis. Results The rate of solitary lymph node metastasis was 135% and the rate of skip metastasis was 44% in this group. 33 patients with non-hopping metastasis were common in the third and sixth groups, and 16 cases were in the skip metastasis group, which was common in the seventh group. There were 14 patients in the second station and 2 patients in the third station (all in the 12th group). Compared with non-leaping metastasis group, leaping metastasis was significantly correlated with tumor infiltration (χ2 = 588, P = 0 016) and tumor size (t = 2 215, P = 0 032). There was no significant difference between the two groups in relapse rate and survival rate. Conclusion Gastric cancer is predominant in gastric cancer with solitary lymph node metastasis. Leaping metastasis and tumor invasion of the full-thickness and tumor size, to the left gastric artery around the lymph nodes more common. D2 radical mastectomy combined with lymph node dissection group 12 is conducive to the prevention of residual leapfrog metastases.