《内蒙古医学杂志》09年第四期
进展期胃癌腹膜后淋巴结（N16组）微转移状况的
临 床 研 究
王腾祺1 张志强1 张凤兰2 牛小叶1 魏育龙2
（1巴彦淖尔市医院肿瘤外科 2病理科，巴彦淖尔 015000）
摘要 目的：为提高胃癌根治手术的疗效，阐明胃癌生物学特性与第16组淋巴结转移的关系, 探讨腹主动脉旁淋巴结清扫术的指征及此术式的临床可行性。方法：2007年1月～2008年6月对58例无远处转移的进展期胃癌行腹主动脉旁淋巴结清扫术, 对反映肿瘤生物学特性的各临床、病理参数进行分析。结果：在58例腹主动脉旁淋巴结清扫术中，发现有第16组淋巴结转移者10例, 转移率为17.2%,而于浸润型胃癌、肿瘤直径大于5cm、肿瘤侵及浆膜以及第2、3站淋巴结受累时, 第16组淋巴结转移率明显增高（p＜0.05）；在第16组的各分区淋巴结中又以16A2和16B1区的转移率更高。全组无手术死亡率, 手术并发症也未见明显增加。结论：进展期胃癌中有相当一部分发生第16组淋巴结转移, 且与胃癌各生物学特性参数相关只要正确地掌握手术适应证, 腹膜后淋巴结清扫术也是相对安全可行的, 其对胃癌手术的彻底性和远期疗效的意义, 有待进一步研究。
关键词 进展期胃癌； 腹膜后淋巴结；清扫术
Studies on Para-aortic Lymph Node Dissection for Advanced Gastric Cancer
WANG Tengqi ZHANG Zhiqiang ZHANG Fenglan,et al.( Department of Tumor Surgery,Bayannaoer Hospital,Inner Mengolia Bayannaoer 015000,China)
Abstract Objective:(1)To assess the significance of the para-aortic lymph node dissection in treatment patients with advanced gastric cancer(AGC),(2)To elucidate the relationship between the para-aortic lymph node (No.16LN) metastasis and the biological behavior of gastric cancer,(3)To make out the appropriate indications for the para-aortic lymph node dissection.Methode:58 case of AGC without remote metastasis were subjected to the para-aortic lymph node dissection from January 2007 to June2008 in Bayannaoer Hospital.Clinico-pathological studies were carried out for all the cases.Results:Ten of the 58 cases were No.16LN positive(17.2%) and the positive rate was significantly increased in cases where the tumor was larger than 5cm in diameter , belonging to the infiltrative type,with serosal involvement and/or N3 positive(P＜0.05).The incidence of complications occurring in our cases was not noticeably increased and there was no operative mortality.Conclusion: para-aortic lymph node metastasis do occur in some of the advanced gastric cancer patients.selective para-aortic lymph node dissection procedure appears to be relatively safe and feasible. The impact of para-aortic lymph node dissectionprocedure on the long-term prognosis of AGC remains to be clarified by further studies.
Key words Advanced gastric cancer; para-aortic lymph node; Dissection
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