论文部分内容阅读
目的总结贲门癌的临床病理特点,探讨贲门癌淋巴转移规律。方法对我院在2000年10月至2004年12月间收治的86例贲门癌患者的临床资料进行回顾性分析。结果本组病例中男性66例,女性20例,平均60岁,以BorrmannⅢ型病例为主,组织学类型绝大部分是腺癌,Ⅰ型贲门癌高分化腺癌的发病率显著高于其他两型(P=0．002、P=0．004);Ⅲ型贲门癌在低分化腺癌中的发病率高于其他两型(P=0．005、P=0．015)。贲门癌第1、2组(34．9％),第3、4组(36．0％),第7-9组(27．9％),第10、11组(15．1％)淋巴结的转移率较高,而第5、6组(11．6％),第12组淋巴结(5．8％)的转移率较低(与同站其余淋巴结组比较,P值均小于0．05)。腹主动脉旁淋巴结转移率很高(58．3％);胃大弯侧和小弯侧之间的淋巴结转移率差异无统计学意义。3型贲门癌阳性淋巴结最远站别和pT分期正相关(r1=0．515,P1=0．05;r2=0．404,P2=0．006;r3=0．423,P3=0．031)。结论贲门癌根治术中应确保清扫第1-4组和第7-11组淋巴结,早期诊断有可能改善贲门癌的预后。
Objective To summarize the clinicopathological features of gastric cardia carcinoma and investigate the regularity of lymphatic metastasis in gastric cardia. Methods The clinical data of 86 patients with cardia cancer treated in our hospital from October 2000 to December 2004 were analyzed retrospectively. Results The group of 66 males and 20 females, average 60 years old, Borrmann Ⅲ type cases, the vast majority of histological types of adenocarcinoma, type Ⅰ cardia cancer was significantly higher incidence of adenocarcinoma than the other two (P = 0.002, P = 0.004). The incidence of type III cardia cancer in poorly differentiated adenocarcinoma was higher than those in the other two types (P = 0.005, P = 0.015). Cardiac cancer in Groups 1 and 2 (34.9%), Groups 3 and 4 (36.0%), Groups 7-9 (27.9%), Groups 10 and 11 (15.1%), , While the rates of metastasis were lower in groups 5 and 6 (11.6%) and group 12 (5.8%) (P <0.05 compared with the other stations in the same station ). There was a high rate of lymph node metastasis in the abdominal aorta (58.3%). There was no significant difference in the rate of lymph node metastasis between the greater curvature side and the lesser curvature side of the stomach. There was a positive correlation between the furthest staged positive lymph node in type 3 GCA and pT staging (r1 = 0.515, P1 = 0.05; r2 = 0.404, P2 = 0.006; r3 = 0.423, P3 = 0). 031). Conclusion In the treatment of cardia cancer, it is necessary to ensure that the lymph nodes in Groups 1-4 and 7-11 are cleaned up. Early diagnosis may improve the prognosis of cardia cancer.