| 余强,周明银,张颖.进展期远端胃癌第12亚组淋巴结转移规律及其临床意义[J].安徽医药,2019,23(2):307-309. |
| 进展期远端胃癌第12亚组淋巴结转移规律及其临床意义 |
| The clinical significance and regularity of subgroup No.12 lymph node metastasis of patients with advanced distal gastric cancer |
| 投稿时间：2017-08-29 |
| DOI： |
| 中文关键词: 胃癌 淋巴结转移 第12组淋巴结 |
| 英文关键词: Gastric cancer Lymph node metastasis No.12 lymph node |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨进展期远端胃癌第12亚组淋巴结转移的规律及其在临床中的意义。方法 回顾性分析信阳市中心医院2013年6月至2015年6月137例行远端胃癌D2根治术中清扫第12组淋巴结的进展期远端胃癌病人的临床病理资料。结果137例进展期远端胃癌第12组淋巴结总转移率为16.06%(22/137)。沿肝动脉(12a)、沿胆总管(12b)、沿门静脉(12p)亚组转移率分别为12.41%、1.46%和2.19%,其中12a组淋巴结转移率明显高于12b组(χ2=10.32,P=0.001)和12p组(χ2=8.45,P=0.001)。高—中分化者第12组淋巴结转移率为5.13%(2/39),低于低分化者的20.41%(20/98)(χ2=4.97,P=0.021)；浆膜受侵者第12组淋巴结转移率为21.79%(17/78),高于浆膜未受侵者的8.47%(5/59)(χ2=4.57,P=0.031)；肿瘤直径≤5 cm者第12组淋巴结转移率为7.14%(4/56),低于肿瘤直径＞5 cm者的22.22%(18/81)(χ2=5.59,P=0.018)。结论 进展期远端胃癌D2根治术行第12组淋巴结的清扫是合理必要的,第12组淋巴结转移在三个亚组的分布有一定的规律,有助于术中指导肝十二指肠韧带淋巴结清扫范围。 |
| 英文摘要: |
| Objective To explore the clinical significance and regularity of subgroup of No.12 lymph node metastasis of patients with advanced distal gastric cancer.Methods The clinical and pathological data of 137 advanced distal gastric cancer cases undergoing D2 radical gastrectomy and No.12 lymph node dissection in XinyangCentral Hospital from June 2013 to June 2015 were analyzed retrospectively.Results The total metastasis rate was 16.06% (22/137).The metastasis rates of lymph nodes around the hepatic artery (12a),the common bile duct (12b) and behind the port vein (12p) were 12.41%,1.46% and 2.19%,respectively.And 12a lymph node metastasis rate was significantly higher than that of 12b (χ2=10.32,P=0.001) and 12p (χ2=8.45,P=0.001).No.12 lymph node metastasis rate (5.13%,2/39) in cases with high-moderately differentiated cancer was lower than those with poorly differentiated cancer (20.41%,20/98) (χ2=4.97,P=0.021).No.12 lymph node metastasis rate (21.79%,17/78) in cases with serous membrane invasion was higher than those without infiltration (8.47%,5/59) (χ2=4.57,P=0.031).No.12 lymph node metastasis rate of cases with tumor diameter ≤ 5 cm (7.14%,4/56) was lower than those with tumor diameter >5 cm (22.22%,18/81) (χ2=5.59,P=0.018).Conclusions It is reasonable and necessary to conduct No.12 lymph node dissection in D2 radical gastrectomy for advanced distal gastric cancer,and the distribution of the three subgroups in hepato-duodenal ligament has certain regularity,which is helpful for guiding the extent of lymph node dissection. |
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