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目的:探讨贲门癌手术切除淋巴结总数及阳性转移个数对患者术后生存的影响。方法:通过问卷调查、入户和(或)电话随访及住院病理结果核查,采用Kaplan-Meier法绘制生存曲线,Log-rank检验比较单纯手术治疗的1955例贲门癌患者不同淋巴结切除总数和不同阳性转移个数的生存期。结果:1386例淋巴结转移阳性的患者中,淋巴结切除数目为1～3枚,4～6枚,7～9枚,≥10枚时,中位生存期分别为30、35、39和63个月,Log-rank检验,χ2=20.626,P<0.001。569例淋巴结转移阴性的患者中,淋巴结切除数目为1～2枚,3～4枚,5～6枚,≥7枚时,中位生存期分别为156、168、212和202个月,Log-rank检验,χ2=5.077,P=0.166。阳性淋巴结转移个数为1枚、2枚、3枚和大于3枚时,中位生存期分别为48、41、36和27个月,Log-rank检验,χ2=25.771,P<0.001。结论:淋巴结切除总数的增加可延长患者术后生存期;阳性转移个数多可缩短患者术后生存期。
Objective: To investigate the total number of resected lymph nodes and the number of positive metastases in patients with cardia cancer after operation. Methods: Survival curves were drawn by Kaplan-Meier method through questionnaire survey, home and / or telephone follow-up and in-hospital pathological findings. Log-rank test was used to compare the total number of different lymph node resections and positive cases in 1955 patients with cardia cancer treated by simple operation Transfer the number of survival. Results: Among 1386 patients with positive lymph node metastasis, the number of lymph node resections was 1 ~ 3, 4 ~ 6, 7 ~ 9, and the median survival time was 30, 35, 39 and 63 months , Log-rank test, χ2 = 20.626, P <0.001. The number of lymph node resections in patients with negative lymph node metastasis was 1 to 2, 3 to 4, 5 to 6, and median of 7 The durations were 156, 168, 212 and 202 months, respectively. Log-rank test, χ2 = 5.077, P = 0.166. The median survival was 48, 41, 36 and 27 months, respectively, with Log-rank test, χ2 = 25.771, P <0.001, with a positive lymph node metastasis of 1, 2, 3 and more than 3. Conclusion: The increase of the total lymph node dissection prolongs the postoperative survival time of patients. The number of positive metastases can shorten the postoperative survival time of patients.