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目的 探讨胃癌哨兵淋巴结位置分布规律以及导致其转移的相关因素。方法 调查2 7例单个转移淋巴结、80例单组转移淋巴结的位置分布 ,比较单个转移淋巴结和 111例无转移淋巴结病人的临床病理参数。结果 2 7个单个转移淋巴结中有 2 5个位于第 1站 ,跳跃转移 2个 ;2 1例胃下区、胃中区癌哨兵淋巴结中 16个在第 3、4组 ,6例胃上区癌哨兵淋巴结中 3个位于第 1组。pT3 期胃癌哨兵淋巴结转移的危险性高于pT1胃癌 ,比数比 (OR)为 4 92 6 (P <0 0 1) ,胃上区癌比胃下区癌哨兵淋巴结更易发生转移 (OR =4 381,P <0 0 5 ) ,早期胃癌哨兵淋巴结的转移危险性低于BorrmannⅠ型胃癌 (OR =0 0 82 ,P <0 0 5 )。结论 胃癌哨兵淋巴结多位于肿瘤附近 ,跳跃转移少见 ;肿瘤侵犯深度以及所在部位与哨兵淋巴结发生转移有关 ,利用胃癌哨兵淋巴结可以指导胃癌淋巴结切除范围的选择
Objective To investigate the location and distribution of sentinel lymph nodes in gastric cancer and its related factors. Methods The distribution of lymph nodes in 27 cases of single lymph node metastasis and 80 cases of single lymph node metastasis was investigated. The clinicopathological parameters of single lymph node and 111 non-metastatic lymph nodes were compared. RESULTS: Twenty-five of 27 single metastatic lymph nodes were located in the first station and two of them were leapfrogged. Twelve of the 12 cases were located in the inferior gastrocnemius, Three of the cancer sentinel lymph nodes were in group 1. The risk of sentinel lymph node metastasis in pT3 gastric cancer was higher than that of pT1 gastric cancer, and the odds ratio (OR) was 4 92 6 (P 0 01). Metastasis of gastric cancer was more likely to be metastatic than sentinel lymph node of gastric cancer (OR 4 381, P <0 05). The metastasis of sentinel lymph nodes in early gastric cancer was lower than that in Borrmann Ⅰ gastric cancer (OR = 0 0 82, P 0 05). Conclusions Sentinel lymph nodes in gastric cancer are mostly located near the tumor, with rare jumping and metastasis. The depth of tumor invasion and the location of the sentinel lymph node are related to the metastasis of the sentinel lymph node. Gastric cancer sentinel lymph node can guide the choice of lymph node dissection range