摘要
目的探讨影响腹腔镜进展期胃癌根治术切除标本中最佳淋巴结送检数目的相关影响因素。方法回顾性分析2018年1月至2020年7月行腹腔镜胃癌根治手术的536例进展期胃癌患者的临床病理资料,记录术后淋巴结送检数目,统计分析各因素对淋巴结送检数目的影响。结果536例患者中,无淋巴结转移147例,有淋巴结转移389例。无淋巴结转移患者中,淋巴结送检数目≥16枚组与淋巴结送检数目<16枚组间肿瘤直径的差异有统计学意义(P=0.027);受试者工作特征(ROC)曲线分析显示,肿瘤直径预测淋巴结送检数目≥16枚的曲线下面积为0.719(95%CI:0.627~0.810,P<0.001),最佳截断值为2.8 cm。有淋巴结转移患者中,淋巴结送检数目≥30枚组与淋巴结送检数目<30枚组间年龄和淋巴结转移的差异有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄和淋巴结转移(N_(3a)和N_(3b))均为影响淋巴结送检数目<30枚的独立因素(P<0.05);ROC曲线分析显示,年龄、淋巴结转移预测淋巴结送检数目≥30枚的曲线下面积分别为0.575(95%CI:0.519~0.632,P=0.008)和0.615(95%CI:0.559~0.672,P<0.001),最佳截断值分别为54岁和6枚。结论肿瘤直径≤2.8 cm的无淋巴结转移患者术后淋巴结送检数目更有可能<16枚;年龄>54岁、淋巴结转移数目≤6枚的有淋巴结转移患者术后淋巴结送检数目更有可能<30枚。在临床工作中需综合考虑各影响因素,保证充足的淋巴结送检数目。
Objective To analyze the factors influencing the optimal number of lymph node detection in laparoscopic radical gastrectomy for advanced gastric cancer.Methods The data of 536 patients with advanced gastric cancer who underwent laparoscopic radical gastrectomy from January 2018 to July 2020 were reviewed,and the clinicopathological data was analyzed.The number of lymph nodes was submitted for detection after surgery,and the factors influencing the number of lymph nodes for detection were analyzed.Results Among the 536 patients,147 had no lymph node metastasis and 389 had lymph node metastasis.In patients without lymph node metastasis,there was a statistically significant difference in tumor diameter between the group with lymph node number≥16 and the group with lymph node number<16(P=0.027).Receiver operator characteristic(ROC)curve analysis showed that the area under curve of the tumor diameter predicting the number of lymph nodes≥16 for detection was 0.719(95%CI:0.627-0.810,P<0.001),and the optimal cut-off value was 2.8 cm.In patients with lymph node metastasis,there were statistically significant differences in age and lymph node metastasis between the group with lymph node number≥30 and the group with lymph node number<30(P<0.05).The results of multivariate Logistic regression analysis showed that age and lymph node metastasis(N_(3a) and N_(3b))were independent factors affecting lymph nodes number<30 for detection(P<0.05).ROC curve analysis showed that the area under curve of age and lymph node metastasis predicting number of lymph node metastasis≥30 for detection were 0.575(95%CI:0.519-0.632,P=0.008)and 0.615(95%CI:0.559-0.672,P<0.001),respectively.The optimal cut-off values were 54 years old and 6.Conclusion Patients with tumor diameter≤2.8 cm without lymph node metastasis were more likely to have<16 lymph nodes for detection.Patients aged>54 years and with no more than 6 metastatic lymph nodes were more likely to have<30 lymph nodes for detection.In clinical work,various influencing factors shoul
作者
王锦姝
王瑞康
张鑫众
王巍
刘刚
WANG Jinshu;WANG Ruikang;ZHANG Xinzhong;WANG Wei;LIU Gang.(Graduate School of Xinxiang Medical University, Xinxiang 453003,China)
出处
《临床肿瘤学杂志》
CAS
2022年第3期227-231,共5页
Chinese Clinical Oncology
基金
国家自然科学基金资助项目(81572794)
河南省自然科学基金资助项目(182300410358)。
关键词
胃癌
淋巴结送检数目
腹腔镜手术
影响因素
Gastric tumor
Number of lymph nodes detection
Laparoscopic surgery
Influencing factor
