Laparoscopic dissection for pelvic lymph node recurrence of thymic carcinoma: A case report

Thymic carcinoma, a rare mediastinal neoplasm, is characterized by extensive local invasion and distant metastasis. To our knowledge, this is the first case report demonstrating the efficacy of laparoscopic dissection for pelvic lymph node metastases from thymic carcinoma. A 64‐year‐old man was found to have a mediastinal mass by CT and underwent radical resection. Six months after resection of his thymic carcinoma, follow‐up CT revealed a gluteal tumor and enlarged pelvic lymph nodes. The gluteal tumor was resected percutaneously. Two months after this procedure, PET showed that the three pelvic lymph nodes had abnormal uptake of ¹⁸F‐fluorodeoxyglucose and had enlarged further. The patient accordingly underwent laparoscopic dissection of these lymph nodes. Pathological examination of all resected specimens showed metastatic thymic carcinoma. We recommend laparoscopic dissection of pelvic lymph node metastases because it provides a clear intraoperative view and is minimally invasive.     

Aspirin reduces lung cancer metastasis to regional lymph nodes

Background

Lung cancer is the main cause of cancer-related death worldwide. The high mortality is probably attributable to early metastasis; however, the mechanism underlying metastasis to regional lymph nodes is still unknown. Cyclooxygenase (COX)-derived prostaglandin E₂ (PGE₂) induces tumor growth and metastasis and is associated with a poor prognosis. The present study investigated the effect of an authentic COX inhibitor, aspirin, on regional lymph node metastasis during the development of lung cancer in mice.

Methods

An orthotopic intrapulmonary implantation model based on male C57BL/6 (6–8-weeks-old) mice was used. The lungs were injected with a solution containing Lewis lung carcinoma (LLC) cells overexpressing green fluorescent protein (GFP) and BD Matrigel^®. The effect of aspirin on mediastinal lymph node metastasis of LCC cells from the primary injection sites was then examined.

Results

The implantation process took approximately 30 s per mouse and operative mortality was 10%. Single pulmonary nodules developed at the implanted site in 95% of animals, and regional mediastinal lymph node metastasis was observed at 14 days post-LLC-GFP cell injection in all mice that formed a primary lung tumor. The mean survival time of mice injected with LLC-GFP cells was 15 ± 3 days (range, 12–22 days). Histopathological analysis revealed that no metastatic tumors developed in the regional mediastinal lymph nodes by Day 10–12 post-LLC-GFP cell injection and no metastasis to distant organs or distant lymph nodes was observed by Day 21 post-injection. Oral administration of aspirin (100 mg/kg, twice a day) after LLC-GFP cell injection inhibited metastasis to the regional lymph nodes, with no significant suppression of primary tumor growth in the lungs. Aspirin treatment led to a significant reduction in mortality (P < 0.0001).

Conclusions

The present lymph node metastasis model is useful for evaluating the efficacy of agents that inhibit tumor metastasis to the regional lymph nodes. Aspirin reduced the metastasis of LLC-GFP cells injection to the regional lymph nodes, with a significant reduction in mortality. These findings suggested that COX inhibitors have potential for preventing lymph node metastasis.     

食管癌术后淋巴结转移术后局部小野放疗疗效

目的：分析食管癌术后锁骨上和（或）纵隔淋巴结转移患者放射治疗的疗效、治疗失败原因以及食管癌术后行局部小野放疗的疗效和影响局控率的预后因素。方法：患者分为两组：（1）淋巴结转移组（第1组）为69例术后锁骨上和（或）纵隔淋巴结转移的食管癌放疗病例，放疗的范围仅包括转移淋巴结区域。（2）术后局部小野放疗组（第2组）为术后放疗的食管鳞癌86例，放疗的范围仅包括肿瘤瘤床，常规分割，中位总剂量59．65Gy，30分次，42d完成。结果：第1组1、2、3年总生存率分别为66．4％，31．1％和11．1％，死亡54例，其中远处转移38例，（70．4%）。第2组中位随访时间47．4个月，1、3、5年生存率分别为：77．4％、42．5％和30．3％。1、3、5年局控率分别为：88．8％、72．0％和57．4％，影响局控率的独立预后因素是肿瘤是否残留。放疗剂量50-60Gy的生存率最佳。结论：食管癌术后锁骨上和（或）纵隔淋巴结转移患者的主要失败原因是远处转移，规则足量化疗是必要的。食管癌术后行局部小野放疗的疗效与包括纵隔和双锁骨上大野放疗的疗效相似。     

纵隔肿大淋巴结的诊断

目的 探讨规范诊断纵隔肿大淋巴结程序及提高诊断效率的临床思路。方法 采用核素断层显像(^99mTc-MIBISPECT)与纵隔镜检查术对纵隔肿大淋巴结进行检查和诊断。结果 ^99mTc-MIBI SPECT对纵隔转移淋巴结诊断的敏感性、特异性和准确性分别为85．19％、93．62％、90．54％；纵隔镜检查术对纵隔不明性质肿物或肿大淋巴结的诊断率为93．33％。结论 ^99mTc-MIBI SPECT对纵隔转移淋巴结的预测具有独特价值；纵隔镜检查术对纵隔肿大淋巴结的诊断准确率最高。为了提高对纵隔肿大淋巴结的诊断效率，必须结合相应疾病的特征，遵循一定的程序和步骤。     

探讨周围型非小细胞肺癌纵隔淋巴结转移相关CT表现

目的 分析周围型非小细胞肺癌(NSCLC)纵隔淋巴结转移的相关CT影像学因素.方法 回顾性分析术前接受胸部增强CT检查的101例周围型NSCLC患者.对所有患者均行纵隔淋巴结清扫术.由2名医师盲法阅读术前CT资料,记录肿瘤的位置、大小、密度、增强CT值、分叶、毛刺及胸膜凹陷情况,纵隔淋巴结是否显示及显示淋巴结的大小、数目及边界情况,采用单因素及多因素分析进行筛选.结果 纵隔淋巴结大小、边界、肿瘤大小、位置、密度、胸膜凹陷及肿瘤病理类型是纵隔淋巴结转移的独立影响因素.结论 周围型NSCLC纵隔淋巴结转移不仅与淋巴结大小相关,还与淋巴结边界、肺癌的大小、密度、位置及胸膜凹陷等多种CT表现相关,综合分析多种因素有助于提高CT诊断周围型NSCLC纵隔淋巴结转移的水平.     

胸段食管癌术后淋巴结转移情况与术后放疗疗效分析

目的探讨胸段食管癌术后淋巴结转移情况及术后放疗效果。方法选取65例胸段食管癌患者,胸上段14例,胸中段27例,胸下段24例;发生淋巴结转移者38例,病灶大小:<3 cm者35例,≥3 cm者30例,所有患者均采用食管癌根治术配合术后放疗,回访3年,观察65例患者治疗转归及不同部分胸段食管癌淋巴结转移特点及术后放疗疗效,对病灶大小及有无淋巴结转移与患者术后1、3年生存率的关系进行分析。结果 65例患在者采用食管癌根治术联合术后放疗后,60例(92.31%)肿瘤得到一定程度的控制,回访3年期间,1年生存率为76.92%(50/65),3年生存率为58.46%(38/65)。胸上段食管癌淋巴结转移以颈部淋巴结转移多见,胸中段及胸下段食管癌以腹腔淋巴结及纵隔淋巴结多见,且胸中段食管癌患者术后1年生存率及3年生存率均明显高于胸上段及胸下段食管癌。病灶<3 cm及无淋巴结转移的患者术后1、3年生存率均显著高于病灶≥3 cm及发生淋巴结转移的患者,P<0.05。结论胸段食管癌术后易发生淋巴结转移,术后联合放疗,可提高患者术后生存率,改善患者预后,提高患者生活质量,是胸段食管癌患者术后发生淋巴结转移重要的有效的治疗手段。     

胸段食管鳞癌淋巴结转移规律和淋巴结清扫方式探讨

目的 研究胸段食管鳞癌淋巴结转移规律,探讨胸段食管癌术中淋巴结清扫方式的依据.方法 回顾性分析480 例行根治术的胸段食管鳞癌患者,标记各部位清扫淋巴结分别送检,进行临床病理资料分析,研究淋巴结转移规律,为食管癌淋巴结清扫范围提供理论依据.结果 胸上、中、下段食管癌颈部淋巴结转移率分别为47.2%、10.5%和2.2%,上纵隔分别为22.6%、23.5%和3.7%,中纵隔分别为7.5%、69.3%和11.0%,下纵隔分别为0.9%、28.6%和33.8%,腹部分别为3.8%、19.7%和33.1%.胸部各段食管癌淋巴结转移部位比较差异有统计学意义(P ＜0.05).病变长度愈长、肿瘤分化越低、肿瘤浸润越深食管癌淋巴结转移率也越高(P ＜0.05).结论 胸上段食管癌淋巴结转移以颈段食管旁、锁骨上、上中纵隔转移多见,胸中段食管癌淋巴结转移具有明显的上下双向转移和跳跃性转移特点,胸下段食管癌淋巴结转移以腹部、中下纵隔转移多见.建议胸上段食管癌行颈、胸、腹三野淋巴结清扫,重点清扫颈段食管旁及锁骨上、下界包括隆突下淋巴结,胸下段食管癌可行胸、腹两野淋巴结清扫,重点清扫隆突下、下胸段食管旁、胃左动脉旁淋巴结,胸中段食管癌淋巴结清扫方式应根据具体情况设定.     

肺癌根治术对单发脑转移的治疗价值

目的:评估非小细胞肺癌合并单发脑转移患者接受外科治疗的有效性。方法:分析行脑部和胸部病灶联合切除的非小细胞肺癌单发脑转移患者的临床及随访资料。结果:21例患者进行了单发脑转移病灶切除和后续的肺癌根治术,18例(86%)患者有纵隔淋巴结转移,其中N1淋巴结阳性8例,N2淋巴结阳性10例。中位生存期32个月(95%置信区间15～49个月),1、2和5年生存率分别为70%、43%、22%。对可能影响预后的指标进行单因素分析,提示淋巴结转移是影响预后的危险因素(P=0.002)。结论:对于非小细胞肺癌单发脑转移的患者,在保证病灶完全切除和手术耐受性的前提下,宜对胸部和脑部病灶同时采取积极的外科治疗策略,以获得最佳疗效。     

Expression of caspase-3 and hypoxia inducible factor 1α in hepatocellular carcinoma complicated by hemorrhage and necrosis

BACKGROUNDHepatocellular carcinoma (HCC) is a malignant tumor that occurs in the liver. Its onset is latent, and it shows high heterogeneity and can readily experience intrahepatic metastasis or systemic metastasis, which seriously affects patients’ quality of life. Numerous studies have shown that hypoxia inducible factor1α (HIF-1α) plays a significant role in the occurrence and development of tumors, as it promotes the formation of intratumoral vessels and plays a key role in their metastasis and invasion. Some studies have reported that caspase-3, which is induced by various factors, is involved in the apoptosis of tumor cells.AIMTo investigate the expression of caspase-3 and HIF-1α and their relationship to the prognosis of patients with primary HCC complicated by pathological changes of hemorrhage and necrosis.METHODSA total of 88 patients with HCC complicated by pathological changes of hemorrhage and necrosis who were treated at our hospital from January 2017 to December 2019 were selected. The expression of caspase-3 and HIF-1α in HCC and paracancerous tissues from these patients was assessed.RESULTSThe positive expression rate of caspase-3 in HCC tissues was 27.27%, which was significantly lower than that in the paracancerous tissues (P < 0.05), while the positive expression rate of HIF-1α was 72.73%, which was significantly higher than that in the paracancerous tissues (P < 0.05). The positive expression rates for caspase-3 in tumor node metastasis (TNM) stage III and lymph node metastasis tissues were 2.78% and 2.50%, respectively, which were significantly lower than those in TNM stage I-II and non-lymph node metastasis tissues (P < 0.05). The positive expression rates of HIF-1α in TNM stage III, lymph node metastasis, and portal vein tumor thrombus tissues were 86.11%, 87.50%, and 88.00%, respectively, and these values were significantly higher than those in TNM stage I-II, non-lymph node metastasis, and portal vein tumor thrombus tissues (P < 0.05). The expression of caspase-3 and HIF-1α in HCC tissues were negatively correlated (r_s = − 0.426, P < 0.05). The median overall survival time of HCC patients was 18.90 mo (95% CI: 17.20–19.91). The results of the Cox proportional risk regression model analysis showed that TNM stage, portal vein tumor thrombus, lymph node metastasis, caspase-3 expression, and HIF-1α expression were the factors influencing patient prognosis (P < 0.05).CONCLUSIONThe expression of caspase-3 decreases and HIF-1α increases in HCC tissues complicated by pathological changes of hemorrhage and necrosis, and these are related to clinicopathological features and prognosis.     

睾丸混合性生殖细胞瘤的超声表现

目的 观察睾丸混合性生殖细胞瘤（TMGCT）的超声表现。方法 回顾性分析我院经手术病理证实的48例TMGCT的超声表现。结果 48例中,22例肿瘤位于左侧睾丸,26例位于右侧睾丸。17例伴腹膜后淋巴结转移,9例伴肺转移,5例伴腹股沟区淋巴结转移,2例伴肝转移,2例伴纵隔转移,1例伴颈部淋巴结转移。28例超声可见睾丸内囊实混合回声病灶,18例低回声病灶,2例稍强回声病灶。38例肿瘤边界不清晰,10例边界清楚;29例肿瘤形态规则,19例形态不规则。CDFI示46例肿瘤内可见彩色血流信号。结论 TMGCT的超声表现有一定的特征性,可为诊断提供影像学依据。     

结直肠癌术后肝转移的影响因素分析

【目的】探讨结直肠癌术后肝转移与其临床病理因素之间的关系,分析其在结直肠癌术后肝转移中的意义。【方法】收集行根治性手术治疗的结直肠癌病例700例,其中结直肠癌术后肝转移170例,无肝转移530例,选择性别、年龄、肿瘤直径、分化程度、Dukes分期、组织学类型、淋巴结转移等临床病理因素分组用χ^2检验进行组间分析。【结果】Dukes分期和淋巴结转移两组中肝转移发生率的差别具有显著性（P〈0．05）,其中DukesA、B、C期肝转移的发生率分别为17．2％、17．4％、36．3％。有淋巴结转移者肝转移的发生率为36．3％,无淋巴结转移者肝转移发生率为17．3％。【结论】肿瘤分期和淋巴结转移是影响结直肠癌肝转移的重要因素。肿瘤病理分期越晚者更易发生肝转移,有淋巴结转移者术后肝转移发生率明显高于无淋巴结转移者。     

Thoracoscopy-assisted treatment for mediastinal metastasis of thyroid cancer: a case report

Advanced thyroid cancer with upper mediastinal lymph node metastasis is not rare in the clinical setting. For patients with severe metastasis, a thoracocervical incision is usually performed for dissection of lymph nodes. However, the difficult operation of three-port thoracoscopy to support performance of a cervical incision in the treatment of upper mediastinal lymph node metastasis has rarely been reported to date. We herein describe a case involving the treatment of thyroid cancer with upper mediastinal lymph node metastasis. The lymph node metastasis was severe, closely adhered to the innominate vein, and fused into a mass. Thoracoscopy with a cervical incision was performed and proved to be a highly difficult surgical maneuver. The patient recovered quickly after the operation. Repeat computed tomography showed no swollen metastatic lymph nodes, indicating that the dissection was thorough. Thoracoscopy with a neck incision is more difficult than conventional longitudinal split sternotomy in the treatment of upper mediastinal lymph node metastasis, but its advantages are less severe trauma and faster recovery. This procedure may be performed by surgeons with proficient skill in cervical surgery and thoracoscopy techniques.     

基于18F-FDG PET/CT显像分析非小细胞肺癌纵隔淋巴结转移的危险因素

目的基于PET/CT显像分析非小细胞肺癌(NSCLC)纵隔淋巴结转移与临床各项指标的关系,探讨纵隔淋巴结转移的危险因素。方法收集接受PET/CT检查的初诊NSCLC患者130例。采用单因素分析纵隔淋巴结转移与性别、年龄、吸烟状况、原发灶最大标准摄取值(SUVmax)、大小、病理类型及分化程度之间的关系,采用多因素Logistic回归分析NSCLC纵隔淋巴结转移的危险预测因素。结果 68例出现区域淋巴结转移。单因素分析得出纵隔淋巴结转移与肺癌原发灶SUVmax、大小、分化程度有关(P<0.05),与年龄、性别、吸烟状况及病理类型无关(P>0.05);多因素Logis-tic回归分析显示仅原发灶SUVmax是影响纵隔淋巴结转移的独立因素。结论NSCLC纵隔淋巴结转移与原发灶SUVmax、大小及分化程度有关;原发灶SUVmax是NSCLC纵隔淋巴结转移的一个独立危险预测因素。     

幽门螺杆菌感染与胃癌肝转移的相关性分析

[目的]探讨幽门螺杆菌(Hp)感染与胃癌肝转移的相关性.[方法]120例胃癌患者按照是否存在肝转移分为肝转移组(n=52)和非肝转移组(n=68),对两组患者临床资料中危险因素进行单因素分析,将与胃癌肝转移有关的因素进行Logistic多因素回归分析,根据14C尿素呼气试验结果将胃癌肝转移患者分为Hp阳性组和Hp阴性组,比较两组患者生存曲线关系.[结果]两组患者在肿瘤分期、淋巴结转移、原发灶浸润深度、脉管浸润、肿瘤大小、Borrmann分型及Hp感染等方面比较差异均具有显著性(P<0.05).经Logistic多元回归分析显示,肿瘤分期、淋巴结转移、原发灶浸润深度、Hp感染是胃癌肝转移发生的独立危险因素.胃癌肝转移患者中Hp阴性组平均生存时间显著长于Hp阳性组(P<0.05).[结论]淋巴结转移、脉管浸润和Hp感染是胃癌肝转移发生的独立危险因素,且Hp感染能够影响胃癌肝转移无进展生存期时间.     

纤维母细胞活化蛋白和转化生长因子β1在胃癌中的表达及其临床意义

目的 研究纤维母细胞活化蛋白(FAP)和转化生长因子β1(TGFβ1)在胃癌组织中的表达,并分析其与胃癌临床病理特征及淋巴结转移间的关系.方法 采用免疫组化方法检测FAP和TGFβ1在42例胃癌和癌旁正常组织中的表达情况.结果 ①正常胃组织中FAP(-);胃癌组织中FAP主要表达于肿瘤相关纤维母细胞胞质中,且弥漫型胃癌表达显著高于肠型胃癌(P<0.05),并与临床病理分期、浸润深度和淋巴结转移呈正相关(P<0.05);②正常胃组织中TGFβ1为(-)或弱(+);胃癌组织中TGFβ1主要表达于瘤细胞胞质,在肿瘤间质纤维母细胞、血管内皮细胞和中性粒细胞偶有表达,且瘤细胞的表达强度与临床病理分期、浸润深度和淋巴结转移呈正相关(P<0.05);③ FAP在肿瘤相关纤维母细胞的表达与TGFβ1在肿瘤细胞的表达呈正相关(P<0.05).结论 从FAP表达与TGFβ1表达的正相关性,推测其可能是通过肿瘤-间质相互作用促进肿瘤演进.FAP特异性表达于胃癌间质纤维母细胞,与多项临床病理指标,尤其是淋巴结转移和肿瘤的病理分型有关,可以作为预测胃癌淋巴结转移和预后的免疫病理学指标,有望成为抗胃癌治疗的一个新的靶向分子.     

人工神经网络模型基于胃癌生物学行为的MSCT影像信息判断淋巴结转移

目的 应用人工神经网络(ANN)分析反映胃癌生物学行为的MSCT影像学信息,建立胃癌淋巴结转移判断模型。方法 收集经手术病理证实的胃癌患者175例,患者术前均接受MSCT检查,术前未接受抗肿瘤治疗,未发现远处转移。根据手术病理是否存在淋巴结转移,分为有淋巴结转移组与无淋巴结转移组。观察测量治疗前MSCT显示的反映胃癌生物学行为的癌肿、淋巴结及临床相关指标。以统计学单因素分析筛选两组间有统计学差异的指标,进一步建立ANN和Logistic回归分析模型判断胃癌淋巴结转移。结果 175例胃癌患者中,手术病理证实共134例存在淋巴结转移,41例无淋巴结转移。单因素分析显示癌肿浆膜浸润、大体类型、最大径线、厚度、强化方式、淋巴结数目、分站、最大淋巴结短径共8项指标在有、无淋巴结转移组之间差异有统计学意义。将其作为输入指标建模,ANN模型判断淋巴结转移的总敏感度、总特异度和总准确率分别为90.30%(121/134)、82.93%(34/41)和88.57%(155/175),而Logistic回归判断淋巴结转移的总敏感度、总特异度和总准确率为85.82%(115/134)、70.73%(29/41)和82.29%(144/175)。结论 采用ANN模型,利用MSCT反映的胃癌生物学行为相关信息,可帮助术前判断患者是否存在淋巴结转移,其效能优于Logistic回归分析。     

低场强MRI对肺癌的诊断价值的研究

目的探讨低场强MRI诊断肺癌的价值。方法回顾经手术或病理证实的肺癌的低场强MRI资料进行分析。结果低场强MRI可清晰显示淋巴结转移、纵隔侵犯及远处转移,明确肿瘤的范围,确定肺癌的手术分期。结论低场强MRI在肺癌的诊断中具有重要的诊断价值。     

血管内皮生长因子D及其受体flt-4在肝癌中的表达及意义

目的探讨肝细胞肝癌(HCC)中血管内皮生长因子D(VEGF-D)及其受体flt-4的表达以及与肝癌临床病理特征如淋巴结转移之间的关系。方法应用免疫组织化学染色法检测48例HCC、28例癌旁组织及12例正常肝组织中VEGF-D的表达及flt-4阳性淋巴管的计数,分析VEGF-D的表达与肝癌临床病理特征的关系。结果HCC中VEGF-D的表达显著高于癌旁和正常肝组织,分别为75.0%(36/48),50.0%(14/28)和41.7%(5/12)(P<0.01);VEGF-D的表达与肝癌淋巴结转移和临床分期呈正相关(P<0.05);VEGF-D及flt-4在有肝门淋巴结转移组中的表达明显高于无淋巴转移组(P<0.05);VEGF-D及其受体flt-4在肝癌组织中的表达具有明显的相关性(P<0.05)。结论VEGF-D及其受体flt-4在肝癌组织中呈高表达,并与肝癌的淋巴结转移密切相关。     

Evaluating the Value of uPAR of Serum and Tissue on Patients With Cervical Cancer

We investigated the relationship between the urokinase type plasminogen activator receptor (uPAR) in sera and tissues of patients with cervical cancer and the clinical and pathological features of the cancer. Immunohistochemistry (SABC method) was used to detect uPAR expression in cervical cancer and normal tissues; ELISA was employed to assay the uPAR levels in cervical cancer and normal tissues and the corresponding sera. The immunohistochemistry results showed that there were 37 cases of uPAR expression in 56 patients of cervical cancer with a positive expression rate of 66%, whereas there was no uPAR expression in normal cervical tissues. The uPAR levels in cancer tissue from patients with cervical cancer (70.92 ± 28.55 ng/100 mg protein) were significantly higher than those of adjacent tissues obtained from the cancer patients (11.01 ± 5.40 ng/100 mg protein) (P < 0.001). Furthermore, the tissue uPAR levels are correlated with the TNM stages, lymph node metastasis, and the degree of differentiation instead of tumor‐infiltrating and vessel thrombosis. Serum uPAR levels of patients (2.38 ± 0.29 ng/ml) were significantly increased compared with health control group (0.50 ± 0.16 ng/ml) (P < 0.001). Single‐factor analysis shows that the serum uPAR levels of preoperative patients are related with clinical grade, lymph node metastasis, vein embolism, and the depth of infiltration instead of tumor differentiation. We conducted multiple regression analysis and found that the factors affecting preoperative serum suPAR include clinical stage (P = 0.000), pelvic lymph node metastasis (P = 0.000), and depth of myometrial invasion (P = 0.001). The serum suPAR levels of patients with cervical cancer after surgery are significantly decreased compared with preoperation (P < 0.001). The uPAR levels of serum and tissue present a positive correlation (r = 0.705, P < 0.001). The soluble uPAR in serum (suPAR) may be a more convenient indicator to reflect the uPAR system activity in vivo. It could be a tumor marker for clinical diagnosis, treatment, and prognosis monitor of cervical cancer.     

淋巴结转移指数与胃癌临床病理特征的相关性研究

目的探讨淋巴结转移指数与胃癌的临床病理特征的相关性,建立一个以淋巴结转移指数预测胃癌N分期的评分系统,为手术者选择合理的淋巴结切除范围提供一定帮助。方法回顾性分析216例胃癌患者的淋巴结转移和临床病理特征之间的相关性,单因素和多因素分析筛选出影响实际淋巴转移病理分期水平高低的临床参数,赋予各参数不同的计分分值。绘制接受者工作特征曲线,确定预测各淋巴结转移病理分期的评分标准。结果单因素分析显示不同肿瘤部位、大小、浸润深度、组织学类型的淋巴结转移病理分期差异具有统计学意义;早期胃癌与进展期胃癌淋巴结转移病理分期的差异具有统计学意义,但多因素分析结果显示肿瘤大小、浸润深度、组织学类型是淋巴结转移病理分期的独立影响因素。结论淋巴结转移指数能更加全面反映胃癌的淋巴结转移情况,是定义胃癌淋巴结转移病理分期的较好方法。