早期胃癌淋巴结转移规律的探讨

目的淋巴结转移是影响早期胃癌手术方式选择和预后的重要因素，因此掌握早期胃癌淋巴结转移规律，为选择合理术式，减少手术创伤和相关并发症，提高患者术后生存质量提供依据。方法回顾性分析本院自2004年1月至2009年1月共105例外科手术切除的确诊为早期胃癌的患者，分析其临床资料以及相关病理检查结果，进行统计学分析比较，分析与淋巴结转移有关的临床病理因素。结果本组共15例患者发生了淋巴结转移，转移率为14．29％。黏膜下癌患者淋巴结转移率高于黏膜内癌；肿瘤直径大于2cm者淋巴结转移率高于直径小于2cm者；低分化癌的淋巴结转移率显著高于高分化癌；有淋巴管浸润的淋巴结转移率明显高于没有淋巴结浸润的患者，P值小于0．05。结论早期胃癌的淋巴结转移主要与肿瘤的大小、浸润深度、分化程度、淋巴管浸润与否有关。与患者的性别、年龄、肿瘤类型关系不大。因此应根据淋巴结转移的风险合理选择早期胃癌的手术方式。

The study of lymph node metastasis in early gastric cancer

Objective To find out the relationship between lymph node metastasis and clinical path- ological specificity, for the purpose of improving survival and quality of early gastric cancer （EGC） patients life. Methods To analyze retrospectively the clinical data EGC of the 105 pa- tients, from January 2004 to January 2009, who have been performed mastectomy. The clinic pathologic data were analyzed retrospectively. We obtained the lymph node metastasis rules and analyzed the possible relationship of lymph node metastasis. Results The rate of lymph node me- tastasis in early gastric carcinoma was 14.29G （15/105）. The rate of lymph node metastasis in mucosal carcinoma was lower than sub mucosal carcinoma. The rate of lymph node metastasis in the tumor of diameter greater than 2cm was higher. The rate of lymph node metastasis in poorly differentiated carcinoma was higher than well differentiated cancer. The cancer with lymphatic vessels was higher than without lymphatic vessels. Conclusion Lymph node metastasis in EGC has been proved to be mainly correlated with the size of tumor, depth of invasion of the carcinoma,histopathological type,lymphatic vessels involvement. Lymph node metastasis has no collection with age of patients, sexy of patients and the gross type of tumor. We may choose right surgical protocol to improve survival rate according to lymph node metastasis.