胃癌横结肠系膜前叶及胰腺被膜转移规律的临床研究  

Clinical research of metastasis rule in the pancreatic capsule and anterior layer of transverse mesocolon in gastric cancer

作　　者：龚龙波[1] 吕孝鹏[1] 孟良[1] 谢志远[1] 张才华[1] 张文涛[1] 

机构地区：[1]东南大学医学院附属徐州医院胃肠外科,221009

出　　处：《中华普通外科学文献（电子版）》2016年第2期112-115,共4页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探讨胃癌患者横结肠系膜前叶及胰腺被膜的转移规律及其对临床的指导意义。方法收集2012年6月至2014年1月东南大学医学院附属徐州医院胃肠外科收治的80例胃癌患者手术标本,免疫组织化学染色及病理学检查判断横结肠系膜前叶及胰腺被膜是否存在癌转移,分析其与胃癌临床病理特征的关系。结果 17例患者横结肠系膜前叶和(或)胰腺被膜免疫组织化学染色检测示癌转移,其中5例同时经病理检查也提示癌转移。胃癌横结肠系膜前叶及胰腺被膜癌转移与肿瘤浸润深度、肿瘤部位、淋巴结转移及TNM分期有关(P<0.05),而与患者的年龄、性别、肿瘤组织分化程度无关。结论胃癌根治术中应选择性地切除横结肠系膜前叶及胰腺被膜,对肿瘤侵及浆膜层及TNM分期为Ⅲ期的胃癌患者应彻底切除横结肠系膜前叶及胰腺被膜,对肿瘤未侵及浆膜层及TNM分期为Ⅰ、Ⅱ期的胃癌患者可不切除横结肠系膜前叶及胰腺被膜。Objective To investigate the metastasis rule and its clinical significance in the pancreatic capsule and anterior layer of transverse mesocolon in gastric cancer. Methods A total of eighty specimens in gastric cancer were collected from June 2012 to January 2014 in the Department of Gastrointestinal Surgery, Xuzhou Hospital, Medical College of Southeast University. The pancreatic capsule and anterior layer of transverse mesocolon were histologically and immunohistochemically analyzed for metastasis, and to analyze its relationship with clinicopathologic characteristics in gastric cancer. Results Metastasis to anterior layer of transverse mesocolon and/or pancreatic capsule happened in 17 patients by immunohistochemistry and 5 patients were detected histologically in the same time. The metastases to the anterior layer of transverse mesocolon and/or pancreatic capsule were found to be associated with tumor invasion depth, tumor location, lymph node metastasis extent and clinical TNM staging（P〈0.05）, but not with age, gender and pathological classification. Conclusions The anterior layer of transverse mesocolon and pancreatic capsule should be selectively dissected in the surgery of distal gastric cancer. If the depth of tumor invasion extends beyond the serosa and in TNM staging Ⅲ, it is necessary to remove the anterior layer of transverse mesocolon and pancreatic capsule, otherwise there is no necessity.

关 键 词：胃癌根治术 横结肠系膜前叶 胰腺被膜 转移 

分 类 号：R735.2[医药卫生—肿瘤]