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目的:探讨远端胃癌各组淋巴结转移的特点,指导远端胃癌根治手术中淋巴结清扫的范围。方法:回顾性分析2010年2月至2014年9月天津医科大学肿瘤医院远端胃癌患者773例接受D2(D2+)胃次全切除术的临床病理资料,分析其淋巴结转移特点。结果:773例远端胃癌患者术后病理证实淋巴结转移为423例(54.72%),各组淋巴结中发生转移的患者所占比例由高至低依次为NO.6、NO.3、NO.4sb、NO.5组淋巴结。N1淋巴结转移率由高至低依次为NO.3、NO.6、NO.5、NO.4d组淋巴结;N2淋巴结转移率由高至低依次为NO.8a、NO.7、NO.1组淋巴结。50.68%的患者出现NO.8a组淋巴结跳跃性转移。结论:远端胃癌根治性手术应注意NO.8a淋巴结转移的可能性,必要时应适当扩大淋巴结的清扫范围。
Objective: To investigate the characteristics of lymph node metastasis in distal gastric cancer and to guide the range of lymph node dissection in radical surgery for distal gastric cancer. Methods: A retrospective analysis of clinical and pathological data of 773 cases of D2 (D2 +) subtotal gastrectomy in patients with distal gastric cancer at Tianjin Medical University Cancer Hospital from February 2010 to September 2014 was retrospectively analyzed. The characteristics of lymph node metastasis were analyzed. Results: There were 423 cases (54.72%) of lymph node metastasis confirmed by pathology in 773 cases of distal gastric cancer. The proportion of patients with lymph node metastasis from high to low was NO.6, NO.3, NO.4sb , NO.5 group of lymph nodes. The rates of N1 lymph node metastasis from high to low were NO.3, NO.6, NO.5 and NO.4d, and the rates of N2 lymph node metastasis from high to low were NO.8a, NO.7 and NO.1 Lymph nodes. Fifty-eight percent of patients had NO.8a lymph node metastasis. Conclusion: Radical surgery for distal gastric cancer should pay attention to the possibility of NO.8a lymph node metastasis, if necessary, should be appropriate to expand the scope of lymph node dissection.