淋巴结切除总数及阳性转移个数对贲门癌患者术后生存期的影响  

Influence of total number of dissected lymph nodes and positive metastatic lymph nodes on postoperative survival of patients with gastric cardia adenocarcinoma

作　　者：原超[1,2] 范宗民[2] 陈曦[2] 李燕[2] 伍玥[2] 李贝[2] 宋昕[2,3] 杨玉花 李学民 王立东[1,2,3] 

机构地区：[1]郑州大学基础医学院癌症研究室郑州450001 [2]郑州大学第一附属医院河南省食管癌重点开放实验室,郑州450052 [3]新乡医学院癌症研究中心,新乡453003 [4]鹤壁大河间卫生院外科,鹤壁458000 [5]磁县医院病理科,磁县056500

出　　处：《郑州大学学报（医学版）》2012年第5期595-597,共3页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金资助项目81071783;国家科技部“863”重大项目2012AA02A503;河南省卫生科技创新人才基金资助项目3047

摘　　要：目的:探讨贲门癌手术切除淋巴结总数及阳性转移个数对患者术后生存的影响。方法:通过问卷调查、入户和(或)电话随访及住院病理结果核查,采用Kaplan-Meier法绘制生存曲线,Log-rank检验比较单纯手术治疗的1955例贲门癌患者不同淋巴结切除总数和不同阳性转移个数的生存期。结果:1386例淋巴结转移阳性的患者中,淋巴结切除数目为1～3枚,4～6枚,7～9枚,≥10枚时,中位生存期分别为30、35、39和63个月,Log-rank检验,χ2=20.626,P<0.001。569例淋巴结转移阴性的患者中,淋巴结切除数目为1～2枚,3～4枚,5～6枚,≥7枚时,中位生存期分别为156、168、212和202个月,Log-rank检验,χ2=5.077,P=0.166。阳性淋巴结转移个数为1枚、2枚、3枚和大于3枚时,中位生存期分别为48、41、36和27个月,Log-rank检验,χ2=25.771,P<0.001。结论:淋巴结切除总数的增加可延长患者术后生存期;阳性转移个数多可缩短患者术后生存期。Aim：To investigate the influence of the total number of surgically dissected lymph nodes（LNs） and the number of positive metastatic LNs on postoperative survival of the patients with gastric cardia adenocarcinoma（GCA）.Methods：The questionnaire,home interview,and（or） telephone follow-up and hospital pathology verification were performed on 1 955 patients with GCA in a period of 35 years （1976~2010）. The Kaplan-Meier survival analysis and Log-rank test were applied to assess the relationship between the survival and total number of surgically dissected LNs and positive metastatic LNs.Results：In 1 386 cases of GCA with lymph node metastasis, when the number of surgically dissected LNs was 1~3, 4~6,7~9, and ≥10,the median survival was 30,35,39,and 63 months,and there was significant difference（ χ2=20.626,P0.001）,in 569 cases of GCA without lymph node metastasis, when the number of surgically dissected LNs was 1~2, 3~4,5~6, and ≥7,the median survival was 156,168,212 and 202 months,and there was no significant difference（χ2=5.077,P=0.166）. The number of metastatic LNs was 1,2,3,and 3, the median survival was 48,41,36,and 27 months,and there was significant difference（χ2=25.771,P0.001）.Conclusion：The increasing of total number of dissected LNs is related with longer survival, while the increasing number of metastatic LNs is related with shorter survival of patients with GCA.

关 键 词：贲门癌 淋巴结转移 预后 淋巴结切除总数 

分 类 号：R735.1[医药卫生—肿瘤]