论文部分内容阅读
目的探讨D2根治术治疗进展期胃癌时清扫第14v组淋巴结的临床价值,分析影响14v组淋巴结转移的危险因素。方法选择2008年12月至2011年5月52例采用D2根治术治疗的进展期胃癌患者,14v组淋巴结无转移患者为未转移组(n=30),14v组淋巴结转移患者为转移组(n=22)。术后随访两年,比较两组患者术后的存活率,采用Logistic回归模型分析影响第14v组淋巴结转移的危险因素。结果经过两年的随访,第14v组淋巴结转移组两年后仅存活8例(36.4%),而未转移组患者两年后存活22例(73.3%),未转移组患者的两年存活率明显高于转移组,差异有统计学意义(χ2=7.107,P<0.01)。通过Logistic回归模型对52例进展期胃癌的原发灶部位、肿瘤大小、淋巴结分期、浸润深度进行多因素分析显示,原发灶部位、淋巴结分期是影响其第14v组淋巴结转移的独立危险因素。结论采用D2根治术治疗进展期胃癌,应将14v组淋巴结清扫干净,这将明显提高患者术后生存率。
Objective To explore the clinical value of D2 radical operation in the treatment of lymph node metastasis in patients with advanced gastric cancer, and to analyze the risk factors affecting lymph node metastasis in 14v group. Methods Fifty-two patients with advanced gastric cancer treated with D2 radical resection were selected from December 2008 to May 2011. Patients with no lymph node metastasis in the 14V group were non-metastatic patients (n=30). Patients with lymph node metastasis in the 14V group were metastatic patients (n =22). After two years of follow-up, the survival rate of the two groups was compared. Logistic regression model was used to analyze the risk factors of lymph node metastasis in the 14th group. Results After two years of follow-up, the 14v group lymph node metastasis group survived only 8 cases (36.4%) after two years, while the non-metastatic group survived 22 years (73.3%) after two years, and the two-year survival rate of patients without metastasis group. The difference was statistically significant (χ2=7.107, P<0.01). A multivariate analysis of the primary tumor site, tumor size, lymph node staging, and infiltration depth of 52 advanced gastric cancers by Logistic regression model revealed that the primary tumor site and lymph node staging were independent risk factors affecting lymph node metastasis in the 14th group. Conclusion The use of D2 radical resection for advanced gastric cancer should clear away the lymph nodes in the 14V group, which will significantly improve the postoperative survival rate.