进展期胃癌 No.12淋巴结转移规律对手术范围的指导意义

摘要

Objective To explore the regularity of No.12 lymph node metastasis in advanced gastric carcinoma to guide the extent of hepatoduodenal ligament lymphadenectomy.Methods The clinicopathological data were analyzed for 21 7 patients with advanced gastric carcinoma undergoing radical surgery at our hospital from January 2013 to December 2014.The number of detected lymph nodes was recorded.The sum and average numbers of detected lymph nodes,overall ratio of lymph node metastasis and No.12a,No.12p,No.12b lymph node metastases were calculated and the related risk factors for No.12p lymph node metastasis analyzed.Results A total of 9,490 (16-107)lymph nodes were detected from surgical specimens of 21 7 patients with advanced gastric carcinoma.And the average number of detected lymph nodes was 43.73±14.05.The total ratio of lymph node metastasis was 75.58%(164/21 7).The metastatic rate of No.12 lymph node was 28.1 1 % (61/21 7).In these cases,the numbers of No.12a,No.12p and No.12b lymph node metastasis were 50 (23.04%),26 (1 1 .98%)and 1(0.46%)respectively.The risk factors associated with No.12p lymph node metasta-sis were tumor location,depth of invasion and Nos.5 & 12a lymph node metastases.Conclusions The metastasis of No.12 lymph node in advanced gastric carcinoma has some regularity so that it may guide the extent of hepatoduodenal ligament lymphadenectomy.%目的分析进展期胃癌 No.12淋巴结的转移规律,为肝十二指肠韧带淋巴结切除范围提供参考依据。方法选择2013年1月至2014年12月行根治性切除手术的进展期胃癌217例,记录每例病人的淋巴结总数,计算总体淋巴结转移率及 No.12a,12p 和 No.12b 淋巴结转移率,并分析No.12p 淋巴结转移的相关危险因素。结果217例手术标本共检出淋巴结9490枚(16~107枚),平均(43.73±14.05)枚/例。217例中164例有淋巴结转移,总体淋巴结转移率为75.58%,其中61例(28.11%)有 No.12淋巴结转移。61例 No.12淋巴结转移病例中,50例(23.04%)发现 No.12a 淋巴结转移,26例(11.98%)发现 No.12p 淋巴结转移,仅 1例(0.46%)发现 No.12b 淋巴结转移。No.12p 淋巴结转移的相关危险因素有肿瘤部位、肿瘤侵犯深度、No.5及 No.12a 淋巴结转移。结论进展期胃癌的 No.12淋巴结转移有明显规律,有助于指导肝十二指肠韧带淋巴结切除范围。