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目的 探讨胃癌临床病理特征与淋巴结转移的关系 ,为临床进行合理的淋巴结清扫范围提供依据。方法 统计 12 0 0例胃癌标本 ,术后常规解剖原发灶及各组淋巴结 ,并标记和计数 ,计算肿瘤部位、浸润深度、Bor rmann分型及分化程度与淋巴结转移率的关系。结果 胃癌的淋巴结转移率为 73 % ,转移度为 35 6 % ;C、M、A区及全胃癌淋巴结转移率为 6 0 3 %、5 5 4%、6 3 1%和 88 4% ;早期胃癌、浆膜内和浆膜外浸润的淋巴结转移率依此呈递增趋势 (P <0 0 5 ) ;BorrmannⅢ、Ⅳ型胃癌淋巴结转移率明显高于BorrmannⅠ、Ⅱ型 (P <0 0 5 ) ;分化差者明显高于分化好者 (P <0 0 5 )。结论 术中淋巴结清扫应按胃癌的临床病理分期、部位、大小、大体分型和分化程度作出判断 ,并结合不同分区淋巴结分组、分站转移特点 ,合理选择淋巴结清扫范围。
Objective To investigate the relationship between the clinicopathological features of gastric cancer and lymph node metastasis, and to provide a basis for rational lymph node dissection. METHODS: A total of 200 gastric cancer specimens were collected and routinely dissected. The primary foci and lymph nodes from each group were labeled and counted. The relationship between tumor location, depth of invasion, Bor rmann classification and differentiation and lymph node metastasis was calculated. Results The lymph node metastasis rate of gastric cancer was 73%, and the degree of metastasis was 35.6 %. The lymph node metastasis rates of C, M, A and total gastric cancer were 60%, 55%, 63% and 884%; The lymph node metastasis rate in gastric cancer, serosal infiltration, and extraserosial infiltration increased accordingly (P < 0.05). The lymph node metastasis rate of Borrmann III and IV gastric cancer was significantly higher than that of Borrmann I and II (P <0 05). Those with poor differentiation were significantly higher than those with well differentiation (P < 0.05). Conclusion The intraoperative lymph node dissection should be judged according to the clinical pathological stage, location, size, gross classification and differentiation of gastric cancer. Combined with the characteristics of different regional lymph node grouping and subsite metastasis, reasonable range of lymph node dissection should be selected.