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目的分析胃癌腹主动脉旁淋巴结转移规律以及淋巴结清扫对治疗效果的影响,为临床治疗提供参考依据。方法选取2006年5月～2012年5月6年间某院诊治的胃癌患者121例作为研究对象,按淋巴结清扫与否分为两组,行腹主动脉旁淋巴结淋巴结清扫的89例患者为实验组,行常规淋巴结清扫的32例患者为对照组,两组均进行化疗,对两组患者的淋巴结转移规律以及临床结局进行比较分析。结果 Nol6淋巴结转移最常见的两个区为16a2与16bl;腹主动脉周围淋巴结转移率Tl-T4分别为0%、33.3%、38.7%、42.2%,不同侵犯深度间转移率差异有统计学意义(P﹤0.05);浆膜侵出阴性者和阳性者的淋巴转移率分别为17.1%和70.8%,转移率差异有统计学意义(P﹤0.05)。实验组患者术后复发率为7.9%,3年生存率为79.8%,对照组患者术后复发率为18.8%,3年生存率为40.6%,差异均有统计学意义(P﹤0.05)。结论胃癌腹主动脉旁淋巴结转移率与肿瘤侵犯深度和浆膜侵出程度密切相关,淋巴结清扫可以提高胃癌患者的3年生存率。
Objective To analyze the regularity of para-aortic lymph node metastasis and lymph node dissection in gastric cancer and to provide reference for clinical treatment. Methods A total of 121 gastric cancer patients diagnosed and treated in a hospital from May 2006 to May 2012 were divided into two groups according to lymph node dissection or not. 89 patients undergoing para-aortic lymph node dissection were selected as experimental group , 32 patients undergoing conventional lymph node dissection were the control group. Both groups were treated with chemotherapy. The regularity of lymph node metastasis and clinical outcome were compared between the two groups. Results The most common two regions of Nol6 lymph node metastasis were 16a2 and 16bl. The rates of lymph node metastasis around the abdominal aorta were 0%, 33.3%, 38.7% and 42.2%, respectively. There was significant difference in the metastasis rate between different invasion depths (P <0.05). The rates of lymphatic metastasis were 17.1% and 70.8% in serosal invasion and positive cases, respectively. There was significant difference in metastasis rate (P <0.05). The recurrence rate was 7.9% in the experimental group and 79.8% in the 3-year group. The recurrence rate was 18.8% and the 3-year survival rate was 40.6% in the control group. The difference was statistically significant (P <0.05). Conclusion The lymph node metastasis rate of gastric aorta is closely related to the depth of tumor invasion and serosal invasion. Lymph node dissection can improve the 3-year survival rate of gastric cancer patients.