近端胃癌手术时淋巴结清扫范围、数目及转移的研究  

The relationship between the resection extent and number of lymph node dissection and the effect of metastatic lymph node number on the prognosis of proximal gastric cancer

作　　者：刘文[1] 彭开勤[1] 龚少敏[1] 刘丽江[2] 张应天[1] 

机构地区：[1]武汉市第六医院普外科,430015 [2]江汉大学医学与生命科学学院病理教研室

出　　处：《中华普通外科杂志》2003年第12期714-716,共3页Chinese Journal of General Surgery

摘　　要：目的研究近端胃癌手术时淋巴结切除范围、数目、转移和预后的关系。方法行D2或D3 术式的近端胃癌标本 ,全数摘取淋巴结 ,比较全胃切除和近端胃切除的淋巴结切除数目并判断预后。结果本组 31例共取淋巴结 1971枚 ,平均 6 3枚 /例。近端胃切除 5 7枚 /例 ,全胃切除71枚 /例 ,左半胰切除 6 4枚 /例 ,保留左半胰 6 3枚 /例。新分期N1、N2 、N3 5年生存率分别为 36 %、11%、0。结论随着癌肿侵犯范围扩大 ,必须扩大淋巴结切除范围 ;保留左半胰不影响淋巴结切除数目 ;新的定量N分期在评价预后方面优于旧的定性N分期。Objective To study the relation between the surgical extent and number of lymph node dissection and the effect of metastatic lymph node number on the prognosis of proximal gastric cancer. Method Thirty-one patients with proximal gastric cancer underwent D_2 or D_3 operation, and lymph node were harvested from specimen. The number of lymph node dissection in proximal gastrectomy was compared with that in total gastrectomy. Results A total of 1971 lymph nodes were obtained from the 31 specimens, the mean was 63 per case. There were 57 lymph nodes per case for patients with proximal gastrectomy and 71 per case with total gastrectomy,64 per case with left half pancreaticosplenectomy and 63 per case with splenectomy. According to the new 5th N stage system, the 5 year survival of N_1,N_2,N_3 were 36%, 11%, and 0 respectively. Conclusion Along with the wide invasion of the carcinoma wide resection with extended lymph node dissection is mandatory, reserved left half of the pancreas has no influence on the number of harvested lymphnode, the new quantitative N staging is superior to the old in predicting the prognosis.

关 键 词：胃癌 淋巴结清扫范围 转移 淋巴转移 预后 

分 类 号：R735.2[医药卫生—肿瘤]