Ⅱ~Ⅲ期胃癌根治术中淋巴结清扫数目与远期复发、死亡的关系探讨  

Ⅱ~ⅢDiscuss the Relationship between the Number of Lymph Node Dissection and Long-term Recurrence and Death in Stage Gastric Cancer Patients

作　　者：岑磊磊 朱桂华 CEN Lei-lei;ZHU Gui-hua(Nantong Tongzhou Hospital of Traditional Chinese Medicine,Nantong 226300,Jiangsu Province,China)

机构地区：[1]南通市通州区中医院,江苏南通226300

出　　处：《罕少疾病杂志》2025年第1期119-120,123,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的 探讨Ⅱ~Ⅲ期胃癌患者根治术中淋巴结清扫数目与远期复发、死亡的关系。方法 回顾性分析2018年12月至2020年12月期间本院收治的186例Ⅱ~Ⅲ期胃癌并行根治术患者的临床资料,并对患者随访至2022年12月。根据国际抗癌联盟要求和术中淋巴结清扫数目分为≥25枚组(88例)和15~25枚组(98例),在控制性别、年龄、肿瘤大小、肿瘤部位等变量的前提下,采用COX风险回归分析淋巴结清扫数目与胃癌患者远期复发和死亡的关系。结果 随访2年后,186例患者中胃癌复发61例,死亡38例,复发率和死亡率分别为32.80%和20.43%。单因素分析显示,≥25枚组患者胃癌的复发率为25.00%低于15~25枚组的39.80%(P<0.05);≥25枚组患者的死亡率为12.50%低于15~25枚组的27.55%(P<0.05);COX风险回归分析显示,淋巴结清扫数目是胃癌患者远期复发和死亡的危险因素(HR=2.776、1.669,P<0.05)。结论 Ⅱ~Ⅲ期胃癌患者根治术中淋巴结清扫数目与远期复发、死亡显著相关,且淋巴结清扫数目≥25枚患者胃癌远期复发、死亡的风险较低。Objective To investigate the relationship between the number of lymph nodes dissected during radical operation and long-term recurrence and death in patients with stageⅡ~Ⅲgastric cancer.Methods The clinical data of 186 patients with stageⅡ~Ⅲgastric cancer who underwent radical operation in our hospital from December 2018 to December 2020 were retrospectively analyzed,and the patients were followed up until December 2022.According to the requirements of the International Union against Cancer and the number of intraoperative lymph nodes dissection,the patients were divided into groups≥25(88 cases)and groups 15-25(98 cases).COX risk regression was used to analyze the relationship between the number of lymph nodes dissection and long-term recurrence and death in patients with gastric cancer,with gender,age,tumor size,tumor site and other variables controlled.Results After 2 years of follow-up,61 cases of gastric cancer recurred and 38 cases died.The recurrence rate and mortality rate were 32.80%and 20.43%,respectively.Univariate analysis showed that the recurrence rate of gastric cancer in≥25 patients was 25.00%,which was lower than that in 15-25 patients(39.80%)(P<0.05).The mortality rate of≥25 patients was 12.50%lower than that of 15-25 patients(27.55%)(P<0.05).COX risk regression analysis showed that the number of lymph nodes dissected was a risk factor for long-term recurrence(HR=2.776,P<0.05)and death in patients with gastric cancer(HR=1.669,P<0.05).Conclusion The number of lymph nodes dissected during radical operation is significantly correlated with long-term recurrence and death in patients with stageⅡ~Ⅲgastric cancer,and the risk of long-term recurrence and death is lower in patients with more than 25 lymph nodes dissected.

关 键 词：胃癌 根治术 淋巴结清扫数目 远期复发 死亡 病理分期 

分 类 号：R573[医药卫生—消化系统]