文章摘要
秦龙,罗彬予,田云鸿.NO.4sa、4sb组淋巴结阳性率与进展期胃上部癌行脾门淋巴结清扫的相关性[J].安徽医药,2020,24(6):1106-1108.
NO.4sa、4sb组淋巴结阳性率与进展期胃上部癌行脾门淋巴结清扫的相关性
Correlation between lymph node positive rate in NO.4sa and NO.4sb groups and splenic hilar lymph node dissection for advanced upper gastric cancer
  
DOI:10.3969/j.issn.1009?6469.2020.06.011
中文关键词: 胃肿瘤/外科学  胃切除术 /方法  淋巴结切除术  进展期胃上部癌  NO.4sa、NO.4sb组淋巴结  脾门淋巴结
英文关键词: Stomach neoplasms/surgery  Gastrectomy / methods  Lymph node excision  Advanced upper gastric cancer  Lymph nodes in NO.4sa and NO.4sb groups  Splenic hilar lymph node
基金项目:四川省卫健委科研课题普及应用项目( 19PJ061);南充市研发资金项目( 18YFZJ0015)
作者单位E-mail
秦龙 南充市中心医院胃肠外科四川南充 637000  
罗彬予 南充市中心医院胃肠外科四川南充 637000  
田云鸿 南充市中心医院胃肠外科四川南充 637000 drtianyunhong@126.com 
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中文摘要:
      目的分析进展期胃上部癌 NO.4sa、NO.4sb组淋巴结阳性率与脾门淋巴结阳性率关系来指导是否行脾门淋巴结清扫术。方法选取南充市中心医院 2016年 12月至 2018年 12月腹腔镜下进展期胃上部癌根治术的病人 92例,所有病人术中均常规清扫 NO.4sa、NO.4sb及脾门淋巴结。对比 NO.4sa、NO.4sb阳性组及阴性组脾门淋巴结阳性检出率。结果 NO.4sa、NO.4sb阳性组 25例,其中脾门淋巴结阳性 5例,占 20.00%;NO.4sa、NO.4sb阴性组 67例,脾门淋巴结阳性 3例,占 4.48%;两者比较差异有统计学意义(P<0.05)。结论 NO.4sa、NO.4sb组淋巴结可视为脾门淋巴结的“前哨淋巴结”。术中冰冻或快速石蜡切片检查 NO.4sa、 NO.4sb阳性或 NO.4sa、NO.4sb虽为阴性但脾门淋巴结有明显肿大者,则需行脾门淋巴结清扫术以降低术后复发、转移风险。
英文摘要:
      Objective To analyze the relationship between the positive rate of lymph nodes in NO.4sa and NO.4sb groups and thepositive rate of splenic hilum lymph nodes in advanced gastric cancer patients to guide whether to perform splenic hilar lymphade?nectomy.Methods A total of 92 patients undergoing laparoscopic radical gastrectomy for upper gastric cancer from December2016 to December 2018 in Nanchong Central Hospital were selected.All patients underwent routine removal of NO.4sa,NO.4sb and splenic hilar lymph nodes.The positive detection rates of splenic hilar lymph nodes in the positive and negative groups of NO.4saand NO.4sb were compared.Results There were 25 cases in the positive group of NO.4sa and NO.4sb,among which 5 cases had positive detection of splenic hilar lymph node,accounting for 20.0%;there were 67 cases in the negative group of NO.4sa and NO.4sb,among which 3 cases had positive detection of splenic hilar lymph node,accounting for 4.48%.The difference between the two groups was statistically significant(P<0.05).Conclusions The lymph nodes of NO.4sa and NO.4sb groups can be regarded as“sentinel lymph nodes”of splenic hilar lymph nodes.During the operation,if frozen or rapid paraffin sections show NO.4sa andNO.4sb positive or even if NO.4sa and NO.4sb are negative but the splenic hilar lymph nodes show obvious enlargement splenic hi?lar lymph node dissection is needed to reduce the risk of recurrence and metastasis.
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