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目的 使胃癌手术根治度的判定标准具体客观,对胃癌手术预后的判断具有可靠性和可信性。方法 采用日本胃癌规约12 版中对胃癌手术根治度划为A、B、C 的标准,对1980 年12 月～1990 年12 月间手术切除的533 例胃癌根治度与预后的关系进行评价。结果 A 根治度157 例,B 根治度209 例,C 根治度167 例,其5 年生存率分别为80-9 % 、34-9 % 和9-0 % 。在B 根治度中,淋巴结清除站数> 淋巴结转移站数(D> N) 的5 年生存率为48-0 % ,D= N 为22-4 % 。二者差异有显著性( P<0-05) 。在根治性胃切除时意外发生切缘癌残留,A、B 根治度下降至C 根治度者分别为6-0 % 和12-2 % 。结论 胃癌淋巴结清除的站数应大于淋巴结转移的站数,即D> N。术中应检查切除胃标本切缘距肿瘤缘的距离是否充分,以防止胃切缘癌残留。
Objective To make the criteria for the determination of gastric cancer surgery specific and objective, and to have a reliable and credible judgment for the prognosis of gastric cancer surgery. Methods The relationship between radical cure degree and prognosis of 533 patients with surgical resection between December 1980 and December 1990 was evaluated by using the Japanese Gastric Cancer Protocol 12 standard for the radical surgery of gastric cancer as A, B, and C. Results There were 157 cases of radical cure A, 209 cases of B radical cure, and 167 cases of C radical cure. Their 5-year survival rates were 80-99%, 34-9%, and 9-00%, respectively. In the B radical cure, the 5-year survival rate of lymph node clearance sites> lymph node metastatic sites (D>N) is 48–0 %, and D= N is 22–4 %. There was a significant difference between the two (P<0-05). In the case of radical gastrectomy, there was an accidental resection of residual cancer, and the cure rate of A and B decreased to C radical treatment was 6-0 % and 12-2 %, respectively. Conclusions The number of lymph node clearance sites in gastric cancer should be greater than the number of lymph node metastases, that is, D>N. During the operation, the distance between the margin of the resection of the gastric specimen and the margin of the tumor should be examined to ensure that the resection of the resection margin of the gastric cancer is prevented.