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目的探讨淋巴结取材方法对胃癌淋巴结检查数目及分期的影响。方法 36例接受根治性切除手术的进展期胃癌病例,根据淋巴结取材方法分为新鲜组(n=9)、固定组(n=9)和脱脂组(n=18);记录每例患者的淋巴结数目,分别计算全组及亚组患者的淋巴结总数和平均值,比较亚组患者的淋巴结数目、转移淋巴结数目及pN分期。结果本组36例总体淋巴结转移率72%。新鲜组检出淋巴结(22.11±10.28)枚/例,固定组检出淋巴结(21.89±6.57)枚/例(t=0.052,P=0.960),故合并为传统组(n=18);脱脂组检出淋巴结(55.83±16.77)枚/例(t=14.129,P<0.001)。传统组检出47枚(2~11枚/例)淋巴结转移,脱脂组检出223枚(2~77枚/例)淋巴结转移(t=2.295,P=0.035)。与传统组相比较,脱脂组pN0-pN2病例明显减少,pN3a和pN3b病例明显增加(x~2=9.602,P=0.040)。结论脱脂法可以获取更多的淋巴结,淋巴结转移数目也随之增加,pN分期上移。
Objective To investigate the effect of lymph node sampling on the number and staging of lymph nodes in gastric cancer. Methods 36 cases of advanced gastric cancer undergoing radical resection were divided into fresh group (n = 9), fixed group (n = 9) and degreasing group (n = 18) The total number of lymph nodes and the average value of the patients in all groups and subgroups were calculated. The number of lymph nodes, the number of metastatic lymph nodes and the pN stage in patients in the subgroup were compared. Results The total lymph node metastasis rate in this group was 72%. The number of lymph nodes (22.11 ± 10.28) / group in the fresh group and the lymph node in the fixed group (21.89 ± 6.57) / group (t = 0.052, P = 0.960) Lymph nodes were detected (55.83 ± 16.77) pieces / case (t = 14.129, P <0.001). A total of 47 lymph node metastases were detected in the traditional group (n = 223), 223 (n = 77) cases in the degreased group were detected. Compared with the traditional group, the cases of pN0-pN2 in degreasing group were significantly reduced, and the cases of pN3a and pN3b were significantly increased (x ~ 2 = 9.602, P = 0.040). Conclusion The degreasing method can obtain more lymph nodes, the number of lymph node metastasis also increases, pN stage up.