进展期胃下部癌No.14v淋巴结转移的危险因素

目的探讨进展期胃下部癌No.14v淋巴结转移的危险因素。方法分析2013年1月至2016年12月247例胃下部癌病人的临床资料,所有病人均行胃癌D2+No.14v淋巴结切除术。记录病人的一般资料、各组淋巴结检出数目及阳性数目,分析No.14v淋巴结转移的危险因素。结果247例共检出淋巴结11 837枚(16~107枚/例),平均(47.92±15.11)枚/例。179例有淋巴结转移,总体淋巴结转移率为72.47%。共获取No.14v淋巴结716枚(1~9枚/例),平均(2.90±1.43)枚/例。247例中No.14v淋巴结转移19例,转移率为7.69%。No.14v淋巴结转移与性别、肿瘤侵犯深度、分化程度、Laurén分型及Borrmann分型不相关(P0.05),与肿瘤大小、部位、pTNM分期以及No.4和No.6淋巴结转移相关(P0.05)。结论进展期胃下部癌病人,原发灶位于胃大弯侧、肿瘤最大径≥4 cm,以及怀疑No.4或No.6淋巴结转移,是No.14v淋巴结转移的危险因素。

Risk factors for No.14v lymph node metastasis in advanced lower third gastric cancer

Objective To investigate the risk factors for group 14v lymph node metastasis in advanced lower third gastric cancer.Methods The clinical data of 247 patients with advanced lower third gastric cancer from January 2013 to December 2016 were retrospectively analyzed.All the patients received D2 gastrectomy plus No.14v lymph node dissection.The general clinical data of the patients,and the number of lymph node dissected and lymph node with positive expression were recorded.The analyses on clinicopathological factors influencing the group14v lymph node metastasis and the correlation between the group14v lymph node metastasis and regional lymph node metastasis were done using Student's t test or Chi-square test.Results Of the 247 patients with advanced lower third gastric cancer,a total of 11 837 (16-107 each patient) lymph nodes were detected,and the average number of detected lymph nodes was 47.92±15.11 in each patient.The total ratio of lymph node metastasis was 72.47% (179/247).A total of 716 (1-9) 14v lymph nodes were harvested,and the average number of detected lymph nodes was 2.90±1.43 in each patient.The metastatic rate of No.14v lymph node was 7.69% (19/247).The results of analysis showed that No.14v lymph node metastasis was correlated with diameter of the tumor,the location of tumor,pTNM stage,No.4 lymph node metastasis and No.6 lymph node metastasis.The other results of analysis showed that No.14v lymph node metastasis was not correlated with sex,invasion depth,histopathologic grading,Laur n type and Borrmann type.Conclusions The tumor located at greater curvature,tumor diameter ≥4 cm,suspected No.4 lymph node metastasis and/or No.6 lymph node metastasis are risk factors of No.14v lymph node metastasis in advanced lower third gastric cancer patients.