胃癌淋巴结包膜外侵犯与预后的关系研究  

Study on relationship between extracapsular spread of lymph node with prognosis in gastric cancer

作　　者：赵玉国[1] 张建文[1] 许瑞庭[2] 

机构地区：[1]郴州市第一人民医院普外科,湖南423000 [2]宁夏回族自治区人民医院微创外科,宁夏银川750021

出　　处：《现代医药卫生》2016年第5期678-680,共3页Journal of Modern Medicine & Health

摘　　要：目的初步探讨胃癌淋巴结包膜外侵犯与预后的关系。方法收集郴州市第一人民医院2007年1~12月符合入选标准的患者80例,以常规HE染色法观察淋巴结转移癌包膜外侵犯情况,标本经常规病理检查为阳性则认为淋巴结有癌转移。80例患者均采用电话预约后门诊复查登记形式进行至少5年随访,截至2012年1月或患者死亡、中途失访。结果胃癌淋巴结包膜外侵犯阳性47例,阴性33例;淋巴结包膜外侵犯阳性例数在T分期、N分期、TNM分期方面比较,差异有统计学意义（P〈0.01）;胃癌预后单因素分析表明,患者平均生存时间与TNM分期、肿瘤大小、术后化疗、CEA水平、包膜外侵犯相关（P〈0.01或0.05）;多因素分析表明,包膜侵犯为胃癌预后的独立因素（P〈0.01）。结论胃癌淋巴结包膜外侵犯对判断胃癌预后有重要作用,淋巴结包膜外侵犯阳性患者预后较差。Objective To investigate the relationship between the extracapsular spread of lymph node with prognosis in gastric cancer. Methods Totally 80 cases conformed to the inclusion criterion were collected from Chenzhou Municipal First People＇s Hospital. The routine HE staining method was used to observe the extracapsular spread situation of lymph nodes in gastric cancer,the samples of the positive routine pathological examination were considered to be lymph nodes metastasis. All 80 cases were followed up for at least 5 years up until January 2012 or death of patient and loss to follow up at halfway by the pattern of outpatient department reexamination and registration after telephone appointment. Results The extracapsular spread of lymph nodes was found to be positive in 47 cases and negative in 33 cases. The cases number of extracapsular spread of lymph nodes had statistical difference in the aspects of the T staging, N staging and TNM staging, and the differences were statistically significant （P〈0.01） ; the single factor analysis of gastric cancer prognosis showed that the average survival time was correlated with the TNM stage, tumor size, postoperative chemotherapy, CEA concentration and extracapsular spread （P〈0.01 or 0.05） ;the multivariate analysis showed that the extracapsular spread of lymph node was an independent prognostic factor for gastric cancer. Conclusion The extracapsular spread of lymph node has an important role for judging the prognosis of gastric cancer,and the prognosis in the patients with extracapsular spread of lymph node is poor.

关 键 词：胃肿瘤 淋巴结 肿瘤分期 肿瘤侵润 预后 

分 类 号：R739.86[医药卫生—肿瘤]