徐荣;
XU Rong;Hospital of Traditional Chinese Medicine in Guang'an City;

• 1:广安市中医医院

摘要(Abstract)：

目的:分析胃癌患者临床病理参数与NO.14v淋巴结转移的关系。方法:行全胃切除和远端胃切除治疗的84例胃癌患者的手术资料,所有患者均摘取No.14v组淋巴结送病理检查,根据检查结果分为NO.14v淋巴结转移转移组与非转移组,分析胃癌患者的性别、年龄、肿瘤浸润深度、临床分期、肿瘤细胞分化程度等临床病理参数与NO.14v组淋巴结转移的关系。结果:84例患者检出NO.14v淋巴结转移25例、转移率为29.76%,共检出阳性淋巴结43枚、每例患者1~3枚、平均(1.7±0.3)枚;肿瘤直径>4 cm、肿瘤根除程度为R1或R2、肿瘤T分期为T3~T4期、肿瘤N分期为N3期、M分期为M1分期的患者,发生NO.14v淋巴结转移的比例明显高于未转移患者,差异有统计学意义(P<0.05);多因素分析显示,T分期、N分期、M分期均为导致胃癌患者NO.14v淋巴结转移的独立危险因素(P<0.05)。结论:胃癌患者TNM分期与NO.14v淋巴结转移存在相关性,病理分期越晚的胃癌患者NO.14v淋巴结转移风险较高。
Objective: To analyze the relationship between clinicopathological parameters and NO.14 v lymph node metastasis in patients with gastric cancer. Methods: The clinical data of 84 patients with gastric cancer who underwent total gastrectomy or distal gastrectomy in our hospital from August2014 to August 2017 were collected. According to the examination results,they were divided into NO.14 v lymph node metastasis group and non metastasis group. The relationship of clinical and pathological parameters including patients' sex,age,depth of tumor invasion,clinical stages and tumor cell differentiation with lymph node metastasis of NO. 14 v was analyzed. Results: Among the 84 patients,25 were detected with NO. 14 v lymph node metastases,and the metastasis rate was 29. 76%. A total of 43 positive lymph nodes were found,which showed each patient had 1 ~ 3,with an average of 1. 7 ± 0. 3.The proportions of tumor diameter > 4 cm,R1 or R2 tumor eradication,tumor T stage of T3 ~ T4,N stage of N3,and M stage of M1 in metastasis group were significantly higher than those in non-metastasis group( P < 0. 05). Multivariate analysis showed that T stage,N stage,and M stage were independent risk factors for NO. 14 v lymph node metastasis in patients with gastric cancer( P < 0. 05).Conclusion: There is a correlation between TNM stages and NO. 14 v lymph node metastasis in patients with gastric cancer. The later the pathological stage is,the higher the risk of NO. 14 v lymph node metastasis is.

关键词(KeyWords)： 胃肿瘤;淋巴转移;根治术;病理学
gastric cancer;lymph node metastasis;radical resection;pathology

Abstract:

Keywords:

基金项目(Foundation): 四川省卫计厅项目(1303581)

作者(Author): 徐荣;
XU Rong;Hospital of Traditional Chinese Medicine in Guang'an City;

Email:

DOI:

参考文献(References)：

• [1]王力,宋国栋,李盟,等.患者术前BMI与胃癌临床病理参数、手术并发症及预后的关系[J].山东医药,2016,56(31):75-77.
• [2]徐巧玲,尤徐阳,吴娜静,等.临床病理学分析结合CEA、CA19-9与CA125检测对诊断胃癌术后腹膜转移的意义[J].标记免疫分析与临床,2016,23(11):1321-1326.
• [3]周慧芳,张琼,罗蓉,等.Mer TK在胃癌组织中的表达及其与临床病理特征和预后的关系[J].中华胃肠外科杂志,2017,20(7):823-825.
• [4]陈若华,汪灏,王萌,等.胃癌肠系膜上静脉旁淋巴结转移的影响因素分析[J].中华胃肠外科杂志,2014,17(2):155-157.
• [5]梁月祥,梁寒,丁学伟,等.进展期胃癌D2根治术中第14v组淋巴结清扫的意义[J].中华胃肠外科杂志,2013,16(7):632-636.
• [6]梁寒.局部进展期胃癌的合理淋巴结清扫范围[J].中华消化外科杂志,2015,14(3):183-186.
• [7]梁寒.第7版UICC—AJCC胃癌TNM分期及日本胃癌新分期胃癌治疗指南的临床应用前景[J].中国肿瘤临床,2012,39(20):1466-1471.
• [8]HUANG C M,CHEN Q Y,LIN J X,et al.Laparoscopic spleen-preserving no.10 lymph node dissection for advanced proximal gastric cancer using a left approach[J].Annals of Surgical Oncology,2014,21(6):2051.
• [9]孟兆清,戴冬秋,曹忠良.第10组淋巴结微转移与胃癌生物学行为的关系及其临床意义[J].中华实验外科杂志,2014,31(10):2339-2340.
• [10]WAKAMATSU Y,SAKAMOTO N,OO H Z,et al.Expression of cancer stem cell markers ALDH1,CD44 and CD133 in primary tumor and lymph node metastasis of gastric cancer[J].Pathology International,2012,62(2):112-119.
• [11]陈思曾,穆建成.老年人胃癌淋巴结转移率与病理及临床预后的关系[J].中华老年医学杂志,2015,34(10):1088-1090.
• [12]陈路川,魏晟宏,叶再生,等.进展期胃癌No.8p淋巴结转移的危险因素及预后分析[J].中华胃肠外科杂志,2017,20(2):218-223.
• [13]JATZKO G R,LISBORG P H,DENK H,et al.A 10-year experience with Japanese-type radical lymph node dissection for gastric cancer outside of Japan[J].Cancer,2015,76(8):1302-1312.
• [14]梁寒.局部进展期胃癌合理淋巴结清扫范围再探讨[J].中国肿瘤临床,2016,43(1):11-14.
• [15]谢建伟,黄昌明,郑朝辉,等.CD44v6与胃癌淋巴结转移及预后关系研究[J].福建医科大学学报,2015(3):145-148.

文章评论(Comment)：