贲门腺癌纵隔淋巴结转移相关因素分析(附118例报告)  

Related factors for mediastinal lymph node metastasis in gastric cardia adenocarcinoma:A report of 118 cases

作　　者：汪金钱[1] 解明然[1] 魏大中[1] 

机构地区：[1]安徽省立医院胸外科,安徽合肥230001

出　　处：《皖南医学院学报》2014年第2期157-158,161,共3页Journal of Wannan Medical College

摘　　要：目的：探讨贲门腺癌纵隔淋巴结转移相关因素，以明确纵隔淋巴结清扫指征。方法：回顾性分析2011年1月～2013年5月118例左胸入路手术治疗贲门腺癌患者临床资料，分析患者临床病理资料与纵隔淋巴结转移的关系。结果：全组病例共清扫纵隔淋巴结362枚，平均清扫每例淋巴结数（3．1＆#177;0．4）枚。纵隔淋巴结转移率为25．4％（30/118），转移度为11．6％（42/362）。肿瘤长度、浸润深度、分化程度、肿瘤是否累及食管下段与纵隔淋巴结转移有关，结果有统计学意义（P≤0．05）。结论：贲门腺癌其分化程度越低，肿块越大（最大直径超过3 cm），浸润越深，食管下端累及越容易发生纵隔淋巴结转移。临床工作中对这些患者应该常规行纵隔淋巴结清扫（主要是下纵隔淋巴结）。Objective：To investigate the related factors affecting the mediastinal lymph node metastasis in patients with gastric cardial adenocarcinoma for indications of necessary lymph node dissection .Methods：The clinical data were retrospectively analyzed in 118 cases of gastric cardial adenocarcinoma undergone surgical treatment in our department between Jan.2011 and May 2013.The outcomes of mediastinal lymph node metastasis were determined on the pathological finding basis of the patients.Results：Totally,362 pieces of mediastinal lymph nodes were dissected,mean（3.1 ＆#177;0.4）pieces,and the rate and ratio of mediastinal lymph node metastasis were 25.4%（30/118） and 11.6%（42/362）,respectively.The metastasis to the mediastinal lymph nodes was associated with tumor size,pathological tumor depth,differentiation and presence or absence of involvement of the lower esophagus .The results were statistically significant （P≤0.05）.Conclusion：Metastasis status of the mediastinal lymph nodes for cardial adenocarcinoma is associated with pathological factors,and occurs more common in cases with poorly differentiated and larger sized tumor （ ＆gt;3 cm in diameter） ,deeper invasion and involvement of lower esophagus.Thus,conventional dissection of the mediastinal lymph nodes,especially the lymph nodes at the inferior mediastinum,is necessary for those types of patients.

关 键 词：贲门腺癌 纵隔淋巴结转移 影响因素 

分 类 号：R735.2[医药卫生—肿瘤]