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目的 分析进展期胃癌胃周淋巴结转移及淋巴结清除与病人预后的关系。方法 对1982－1992年间收治并行手术治疗的进展期胃癌299例进行统计分析。结果 肿瘤进展与淋巴结转移的程度显著相关（P＜0.05）。淋巴结转移有无、淋巴结清扫与术后生存直接相关，对于侵及浆膜下或侵出浆膜并伴有远处淋巴结转移的病例，淋巴结清扫仍能提高术后生存率（P＜0.05）。结论 严格的淋巴结清扫可以提高胃癌病人术后生存率。

Significance of lymph node metastasis and lymph node dissection in prognosis of advanced gastric cancer

Objective To analyze the relationship of prognosis and lymph node metastasis/lymph node dissection in advanced gastric cancer patients.Methods Two hundred and ninety-nine patients with advanced gastric cancer were analyzed in this article.Results Tumor progression was correlated with lymph node metastasis(P<0^05).The 5-year survival of patients who had positive lymph node metastasis was significantly lower than those who had negative lymph node metastasis(P<0^05).Lymph node dissection was correlated with postoperative survival.For patients with tumors that invaded to subserosal layer or beyond serosa with distant lymph node metastasis,extended lymph node dissection could still improve the postoperative survival(P<0^05).Conclusion Strict lymph node dissection during operation for gastric cancer can improve survival of the patients.