摘要
目的 研究Ⅱ期胃癌行D_2根治术检出淋巴结数目与患者预后的关系.方法 回顾性分析中山大学肿瘤防治中心1990年1月至2006年12月期间268例行胃癌D_2清扫术后按照日本胃癌协会（JGCA）第13版分期病理证实为Ⅱ期胃癌患者的临床资料.随访至2008年12月.结果 本组病例平均检出淋巴结（17.3±1.2）枚,其中淋巴结检出数低于15枚者109例,其1、3、5年生存率分别为92.7%、67.8%和50.9%;检出淋巴结数多于或等于15枚者159例,其1、3、5年生存率分别为96.9%、81.0%和66.4%;两组生存率比较,差异有统计学意义（P=0.003）.进一步分析显示.无淋巴结转移组（pN_0组）199例,其中检出淋巴结数目低于15枚者95例,其1、3、5年生存率分别为92.6%、70.4%和55.9%;多于或等于15枚者104例,其1、3、5年生存率分别为97.1%、84.4%和66.8%.两组生存率比较,差异有统计学意义（P=0.047）.而有淋巴结转移组（pN_1组）69例.其中检出淋巴结数目低于15枚者14例,其1、3、5年生存率分别为92.9%、57.1%和34.3%;多于或等于15枚者55例.其1、3、5年生存率分别为96.4%、73.4%和63.8%,两组生存率比较,差异有统计学意义（P=0.036）.结论 以日本胃癌协会（JGCA）第13版为标准的Ⅱ期胃癌患者,D_2根治术后淋巴结检出数目超过15枚者.其生存率优于低于15枚者.
Objective To explore the relationship between the lymph node count and prognosis in stage II gastric cancer.Methods Retrospective analysis was performed for the 268 cases with gastric cancer who underwent parallel D_2 dissection between January 1990 and Dececmber 2006 in the Sun Yat-Sen Cancer Center. The Japanese Gastric Cancer Association （JGCA） 13th edition of pathological staging system was used to define stage Ⅱ gastric cancer. Patients were followed up until December 2008. The Kaplan-Meier method and chi-square test were used for data analysis. All the data were analyzed using SPSS16.0 for Windows. Results The average number of detected lymph nodes was 17.3±1.2. There were 109 patients with detected lymph node 〈15. The 1-, 3-, and 5-year survival rates were 92.7%, 67.8%, and 50.9%, respectively. The number of detected lymph node was 3= 15 in 159 cases, and the 1-, 3-, and 5-year survival rates were 96.9 %, 81.0%, and 66.4%, respectively. The difference between two groups was statistically significant （P=0.003）. Further analysis of the 199 cases with no lymph node metastasis （pN0 group） showed that there were 95 cases with lymph nodes〈15, and the 1-, 3-, and 5-year survival rates were 92.6%, 70.4%, and 55.9%, respectively. There were 104 patients with ≥15 lymph nodes, and the 1-, 3-, and 5-year survival rates were 97.1%, 84.4%, and 66.8 %, respectively. The difference was also statistically significant （P=0.049）. There were 69 cases with lymph node metastasis （PN1 group）, and the 1-, 3-, and 5-year survival rates of 14 patients with lymph nodes 〈15 were 92.9%,57.1%, and 34.3%, respectively. Comparing two groups, the survival rate was significantly different （P=0.034）. There were 55 patients with ≥15 lymph nodes, and the 1-, 3-, and 5-year survival rates were 96.4% , 73.4% , and 63.8%. The difference was statistically significant （P=0.036）. Conclusion In patients with stage Ⅱ gastric cancer as defined by the JGCA 13th edition, the survival rate is better in patients
出处
《中华胃肠外科杂志》
CAS
北大核心
2010年第5期346-349,共4页
Chinese Journal of Gastrointestinal Surgery
基金
广东省科技计划项目（2008B030301079）
关键词
胃肿瘤
Ⅱ期
淋巴结清扫
淋巴结数目
预后
Stomach neoplasms, Phase Ⅱ
Lymph node dissection
Number of lymph node dissection Prognosis
