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目的探讨淋巴结清扫对原发性肝癌伴淋巴结转移患者的疗效。方法回顾性分析60例原发性肝癌伴淋巴结患者的病历资料,按是否行淋巴结清扫分为2组:对照组(未行淋巴结清扫组)30例,治疗组(行淋巴结清扫组)30例。结果处理组患者的半年、1年及2年生存率分别为80.0%、63.3%和56.7%;对照组患者的半年、1年及2年生存率分别为80.0%、60.0%和26.7%。处理组的2年生存率显著高于对照组(P=0.039)。两组患者的术后并发症发生率都很低,且两组间发生率无明显差异。结论对肝癌伴淋巴结转移患者进行淋巴结清扫有益于提高患者的长期生存率。 相似文献
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Nobuhiko Harada Frank Treitschke Toshihide Imaizumi Hans G. Beger 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(2):215-219
Sixty-three patients who had undergone pancreatoduodenectomy for carcinoma of the ampulla of Vater were analyzed with respect
to tumor extent and prognosis. The postoperative mortality rate was 3% and overall survival rates 3 and 5 years after surgery
were 55% and 46%, respectively. pTNM stage did not reflect prognosis after resection in patients at stages 2 and 3, while
pancreatic invasion and regional lymph node metastasis clearly reflected prognosis after resection. Of the 26 patients who
had no pancreatic invasion, regional lymph node metastasis was seen in only 19%, whereas of the 37 patients with pancreatic
invasion, 62% exhibited lymph node metastasis. These factors were significantly correlated (P<0.001). Pancreatic invasion appeared to be an indirect indicator of regional lymph node metastasis. We conclude that, to
improve prognosis for patients with pancreatic invasion, extended resection including extended lymphadenectomy, is a preferable
additional procedure. 相似文献
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胸段食管鳞癌淋巴结转移规律探究 总被引:2,自引:0,他引:2
目的探讨胸段食管鳞癌淋巴结转移规律及其影响因素,以指导淋巴结清扫方式。方法回顾分析漳州市医院2010年4月至2012年7月手术治疗的328例胸段食管鳞癌的临床病理资料,探讨淋巴结转移规律及其影响因素。结果全组328例共清扫淋巴结9937枚,平均30.3枚/例。共437枚、153例有淋巴结转移,转移率46.65%;其中喉返神经旁淋巴结转移18.30%,10.46%喉返神经旁淋巴结为唯一转移部位。胸段食管癌淋巴结转移与肿瘤部位、长度、分化程度及浸润深度明显相关。胸上段食管癌淋巴结转移方向主要向上纵隔及下颈部;胸中段食管癌颈、胸、腹均可发生淋巴结转移;胸下段食管癌主要向腹腔、中下纵隔转移。结论食管上段鳞癌,颈部淋巴结转移率高,应行三野淋巴结清扫;下段食管癌清扫重点在腹腔、中下纵隔;中段鳞癌应提倡进行个体化清扫和适度清扫;分化程度差,浸润程度深的病例应适当扩大清扫范围。胸段食管癌喉返神经旁淋巴结转移率高,均应行喉返神经旁淋巴结清扫。 相似文献
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目的:应用中央区淋巴结转移(central lymph node metastasis,CLNM)强度概念,探讨甲状腺乳头状癌(papillary thyroid carcinoma,PTC)颈侧区淋巴结转移(lymph node metastasis,LNM)危险因素及对其影响。方法:回顾性分析内蒙古医科大学附属医院... 相似文献
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Vater壶腹及乳头癌的淋巴结转移特点及相关因素 总被引:1,自引:0,他引:1
目的 探讨Vater壶腹及乳头癌的淋巴结转移特点及相关影响因素.方法 回顾性分析152例Vater壶腹及乳头癌患者根治术后的淋巴结转移特点,分析其临床病理相关影响因素.结果 对152例Vater壶腹及乳头癌行根治性胰十二指肠切除术,淋巴结转移率为31%,其中T1、T2、T3、T4期淋巴结转移率分别为0、20%(11/54)、26%(19/72)及94%(16/17).淋巴结转移相关因素有:肿瘤直径(<3 cm与≥3 cm相比,P=0.002)、肿瘤分化程度(P=0.012)、十二指肠壁浸润(P=0.008)、T分期(P=0.000)及胰腺受侵(P=0.005).结论 Vater壶腹及乳头癌淋巴结转移率高;根治性手术切除是主要的治疗方式;行肿瘤局部切除时应选择适合的病例. 相似文献
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Sato F Shimada Y Li Z Kano M Watanabe G Maeda M Kawabe A Kaganoi J Itami A Nagatani S Imamura M 《Annals of surgical oncology》2002,9(1):65-70
BACKGROUND: We determined which lymph node metastases were associated with cervical lymph node metastases of thoracic esophageal squamous cell carcinoma. METHODS: A total of 6464 lymph nodes derived from 155 consecutive patients with thoracic esophageal squamous cell carcinoma were stained by immunohistochemistry (antibody: AE1/AE3). Lymph node metastases were mapped according to the mapping scheme of the American Thoracic Society, as modified by Casson et al. (Ann Thorac Surg 1994;58:1569-70). Patients were divided into two groups: those with and without cervical lymph node metastasis (CLNM). Mapping data were examined by uni- and multivariate analysis. RESULTS: Hematoxylin and eosin-positive and AE1/AE3-positive lymph node metastases were found in 59% and 77% of patients, respectively. Twenty-one (55%) of 38 patients in the CLNM(+) group and 30 (26%) of 117 patients in the CLNM(-) group had AE1/AE3-positive lymph node metastasis in the thoracic paratracheal lymph node. Paratracheal lymph node metastasis is only one independent factor for (CLNM), whereas upper thoracic paraesophageal lymph node and pulmonal hilar lymph node status were also significant in univariate analysis. Three (43%) of seven patients with cervical jumping metastasis from the thoracic esophagus had micrometastasis in the paratracheal lymph node. CONCLUSIONS: The paratracheal lymph node is most associated with (CLNM) of thoracic esophageal squamous cell carcinoma. 相似文献
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目的探究甲状腺乳头状癌(PTC)颈部淋巴结跳跃性转移的临床病理特征及其危险因素。
方法回顾性分析2015年7月至2018年11月福建医科大学附属协和医院收治的259例PTC患者临床资料,探究跳跃性侧颈区淋巴结转移的危险因素。
结果PTC颈部淋巴结跳跃性转移的发生率为9.3%(24/259)。单因素分析显示,中央区淋巴结清扫数目在跳跃性转移组中更少(P=0.031);肿瘤最大径<1 cm(P<0.001)及肿瘤位于腺体上部(P=0.012)与PTC患者跳跃性转移的发生有关。多因素分析显示,肿瘤最大径<1 cm(OR=5.934,P<0.001)和肿瘤位于腺体上部(OR=2.812,P=0.023)是PTC患者颈部淋巴结跳跃性转移的独立危险因素。
结论肿瘤最大径<1 cm和肿瘤位于腺体上部的PTC患者侧颈区淋巴结更易发生跳跃性转移。 相似文献
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Sachdev U Murphy K Derzie A Jaffer S Bleiweiss IJ Brower S 《American journal of surgery》2002,183(3):213-217
BACKGROUND: In order to define a future subset of breast cancer patients in whom the axilla may be staged by sentinel lymph node biopsy alone, the conditions under which nonsentinel axillary lymph node metastases occur must be delineated. METHODS: A prospective database including 212 breast cancer patients who underwent sentinel lymph node biopsy followed by completion axillary dissection at our institution was reviewed. A multivariate, logistic, stepwise regression was performed to evaluate the relationship between nonsentinel lymph node metastasis and patient age, primary tumor size, presence of lymphatic invasion, use of radioisotope to identify the sentinel node and degree of metastasis in the sentinel node. RESULTS: Tumor size greater than 2 cm, lymphatic invasion of the primary tumor, macrometastasis in the sentinel node, and use of radioisotope all positively correlated independently with metastasis in the nonsentinel lymph node (P = 0.0001, P = 0.0483, P = 0.0008, P = 0.0271, respectively). CONCLUSIONS: Predictors of nonsentinel axillary node metastasis exist and are important in defining those patients in whom a sentinel lymph node biopsy alone may not be adequate. 相似文献
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胃癌单个淋巴结转移规律及临床意义 总被引:1,自引:0,他引:1
目的分析胃癌淋巴结转移的规律以指导临床规范化治疗。方法对天津医科大学附属肿瘤医院1999年7月至2004年6月间经手术治疗、清扫淋巴结数大于或等于10枚、术后病理证实仅有1枚淋巴结转移的胃癌患者临床资料进行回顾性分析.并对淋巴结跳跃与非跳跃转移、横向与非横向转移患者的资料进行对比。结果全组65例患者共检出淋巴结1415枚.平均21.8枚/例;单个淋巴结转移率的分布从多到少依次为N0.3(30.8%)、No.4(21.5%)、No.6(15.4%)、No.7和No.8(均为6.2%)、No.1和No.2及N0.5(均为4.6%)、No.12(3.1%)和No.14及No.16(均为1.5%);其中跳跃转移20.0%(13/65),横向转移42.2%(19/45)。单因素分析显示.淋巴结跳跃性转移仅与肿瘤大小有关(X2=4.447,P=0.035):淋巴结横向转移与各临床病理因素均无关。但淋巴结跳跃与非跳跃转移、横向与非横向转移间患者的生存曲线差异有统计学意义(P=0.000.P=0.000)。结论胃癌淋巴结转移规律总体遵循由远及近的转移顺序.但跳跃转移和横向转移方式也占有一定比例.对于胃癌淋巴结跳跃转移和横向转移的高危患者.术中应加强相应区域淋巴结清扫以提高患者生存率。 相似文献
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Predicting lymph node metastasis in patients with papillary thyroid carcinoma by vascular index on power Doppler ultrasound 下载免费PDF全文
Ji Hye Lee MD Hyun Joo Shin MD Jung Hyun Yoon MD PhD Eun‐Kyung Kim MD PhD Hee Jung Moon MD PhD Hye Sun Lee PhD Hyeong Ju Kwon MD PhD Jin Young Kwak MD PhD 《Head & neck》2017,39(2):334-340
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Takahiro Osawa Takashige Abe Nobuo Shinohara Toru Harabayashi Ataru Sazawa Kanako Kubota Yoshihiro Matsuno Takeshi Shibata Yuichiro Shinno Shinji Kamota Keita Minami Shigeo Sakashita Akira Kumagai Tatsuya Mori Katsuya Nonomura 《International journal of urology》2009,16(3):274-278
Objectives: To evaluate the prognostic role of different clinico-pathological parameters in node-positive patients treated by radical cystectomy.
Methods: A retrospective multi-institutional study of 435 patients who underwent radical cystectomy between 1990 and 2005 was carried out. Of them, pathological lymph node (LN) metastases were found in 83 patients. Sixty of these 83 patients, whose clinical information and follow-up data were available, were included in the analysis. Twenty-five patients had undergone adjuvant chemotherapy, whereas 35 had not. A Cox proportional hazards model was used to determine the impact of the following clinico-pathological parameters on patient survival: number of resected LNs, number of positive LNs, LN density (defined as the ratio of the number of positive LNs divided by the total number of resected LNs) and adjuvant chemotherapy.
Results: Median follow-up for surviving patients was 41 months (range 4–138) after surgery. The median survival time for all patients was 22 months (95% confidence interval, 15–42 months). At multivariate analysis, LN density of 25% or less, adjuvant chemotherapy and pure urothelial carcinoma were independently significant predictors of survival.
Conclusions: Lymph node density predicts survival in patients with node-positive bladder cancer. 相似文献
Methods: A retrospective multi-institutional study of 435 patients who underwent radical cystectomy between 1990 and 2005 was carried out. Of them, pathological lymph node (LN) metastases were found in 83 patients. Sixty of these 83 patients, whose clinical information and follow-up data were available, were included in the analysis. Twenty-five patients had undergone adjuvant chemotherapy, whereas 35 had not. A Cox proportional hazards model was used to determine the impact of the following clinico-pathological parameters on patient survival: number of resected LNs, number of positive LNs, LN density (defined as the ratio of the number of positive LNs divided by the total number of resected LNs) and adjuvant chemotherapy.
Results: Median follow-up for surviving patients was 41 months (range 4–138) after surgery. The median survival time for all patients was 22 months (95% confidence interval, 15–42 months). At multivariate analysis, LN density of 25% or less, adjuvant chemotherapy and pure urothelial carcinoma were independently significant predictors of survival.
Conclusions: Lymph node density predicts survival in patients with node-positive bladder cancer. 相似文献
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Kroon BK Leijte JA van Boven H Wessels LF Velds A Horenblas S van't Veer LJ 《BJU international》2008,102(4):510-515