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中华普外科手术学杂志(电子版) ›› 2022, Vol. 16 ›› Issue (03) : 279 -282. doi: 10.3877/cma.j.issn.1674-3946.2022.03.013

论著

胃癌患者No.14v淋巴结转移或微转移与临床病理特征及预后关系研究
欧雷1,(), 罗之谦1, 陈旺文1, 龙凯军1   
  1. 1. 570102 海口,海南医学院第一附属医院急诊外科(创伤医学中心二病区)
  • 收稿日期:2021-07-07 出版日期:2022-04-26
  • 通信作者: 欧雷

The relationship between No. 14v lymph node metastasis or micrometastasis and clinicopathological characteristics and prognosis of gastric cancer patients

Lei Ou1,(), Zhiqian Luo1, Wangwen Chen1, Kaijun Long1   

  1. 1. Department 2 of the Trauma Medical Center,The First Affiliated Hospital of Hainan Medical College,Haikou Hainan Province 570102,China
  • Received:2021-07-07 Published:2022-04-26
  • Corresponding author: Lei Ou
  • Supported by:
    Hainan Health Industry Scientific Research Project(20A200131); Hainan Provincial Key Research and Development Project(ZDYF2021205)
引用本文:

欧雷, 罗之谦, 陈旺文, 龙凯军. 胃癌患者No.14v淋巴结转移或微转移与临床病理特征及预后关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2022, 16(03): 279-282.

Lei Ou, Zhiqian Luo, Wangwen Chen, Kaijun Long. The relationship between No. 14v lymph node metastasis or micrometastasis and clinicopathological characteristics and prognosis of gastric cancer patients[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(03): 279-282.

目的

探讨胃癌患者No.14v淋巴结转移或微转移与临床病理特征及预后的关系。

方法

回顾性分析2018年1月至2020年12月行胃癌D2+根治术(联合No.14v淋巴结清扫)的128例胃癌患者临床资料。数据应用软件SPSS 22.0进行处理,单因素分析等级计数资料行秩和检验,其他计数资料行χ2检验;多因素分析行Logistic回归分析;生存情况采用Kaplan-Meier法并行Log-Rank检验。P<0.05为差异有统计学意义。

结果

128例胃癌患者中,病理学检查发现No.14v淋巴结转移者19例(14.8%),No.14v淋巴结阴性者109例,免疫组织化学检查发现No.14v淋巴结微转移者5例(3.9%),No.14v淋巴结的总转移率为18.8%。单、多因素分析结果显示,胃下部肿瘤、Borrmann分型-型、pN3期、脉管浸润及No.6淋巴结转移是胃癌患者No.14v淋巴结转移或微转移的独立危险因素(P<0.05)。术后中位随访时间27个月,转移组与非转移组患者的累积总生存率(37.5% vs. 77.9%)及无病生存率(29.2% vs. 76.0%)比较,差异有统计学意义(Log-Rank χ2=16.142、28.691,P=0.000、0.000)。

结论

胃癌患者No.14v淋巴结转移或微转移与胃下部肿瘤、Borrmann分型-型、pN3期、脉管浸润、No.6淋巴结转移等临床病理特征密切相关,且伴有No.14v淋巴结转移或微转移的胃癌患者预后较差。

Objective

To investigate the relationship between No.14v lymph node metastasis or micrometastasis and clinicopathological features and prognosis in patients with gastric cancer.

Methods

The clinical data of 128 patients with gastric cancer who underwent D2 + radical gastrectomy(combined with No.14v lymph node dissection)from January 2018 to December 2020 were analyzed retrospectively.The data were processed by SPSS 22.0 software. Rank sum test was used for rank count data in univariate analysis χ2 inspection;Logistic regression analysis was performed by multivariate analysis;Kaplan-Meier method and Log-Rank test were used for survival. P < 0.05 was statistically significant.

Results

Among 128 patients with gastric cancer,19 cases(14.8%)had No.14v lymph node metastasis,and 5 cases(3.9%)had No.14v lymph node micrometastasis by immunohistochemical detection of negative No.14v lymph node. The total metastasis rate of No.14v lymph node was 18.8%. Multivariate Logistic regression analysis showed that lower gastric tumor,Borrmann type -,pN3 stage,vascular invasion and No.6 lymph node metastasis were independent risk factors for No.14v lymph node metastasis or micrometastasis in gastric cancer patients(P<0.05),while tumor diameter >5 cm,vascular invasion and No.6 lymph node metastasis were independent risk factors for No.14v lymph node metastasis or micrometastasis in gastric cancer patients(P<0.05). The median follow-up was 27 months,Kaplan-Meier analysis showed that the cumulative overall survival rate(37.5% vs. 77.9%)and disease-free survival rate(29.2% vs. 76.0%)between the metastasis group and the non metastasis group were statistically significant(Log-rank χ2=16.142,28.691,P=0.000,0.000).

Conclusion

No.14v lymph node metastasis or micrometastasis in gastric cancer patients is closely related to the clinicopathological features of lower gastric cancer,Borrmann type -,pN3 stage,vascular invasion,No.6 lymph node metastasis,and the prognosis of gastric cancer patients with No.14v lymph node metastasis or micrometastasis is poor.

表1 128例胃癌患者No.14v淋巴结转移或微转移临床病理特征单因素分析
表2 影响胃癌患者No.14v淋巴结转移或微转移的多因素分析
图1 128例胃癌患者No.14v淋巴结转移与否两组患者术后生存情况曲线
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