Yu W, Kim H S, Choi G S, Suh I S
Department of Surgery, Kyungpook National University, Taegu, Korea.
Hepatogastroenterology. 1999 Jul-Aug;46(28):2658-61.
BACKGROUND/AIMS: We analyzed the significance of metastasis to the subdivided perigastric lymph node stations according to the distance from the primary gastric cancer, and the appropriateness of the recent change in the Union Internacional Contra la Cancrum (UICC) tumor node metastasis (TNM) system.
Gastrectomy was performed in 753 patients with gastric cancer. The perigastric lymph nodes were divided into 6 stations according to the Japanese classification. These were subdivided into 2 categories according to the distance from the primary tumor: -1, nodes within 3 cm of the edge of the tumor; and -2, nodes more than 3 cm from the edge of the tumor. Survival rates were calculated with the Kaplan-Meier method, and the difference between each group was evaluated by the log-rank method.
The frequency of metastasis to the subdivided perigastric lymph node stations, numbered 1-1 to 6-2, varied between 10.0% and 41.1%. The 5-year survival rate of the patients with positive 6-1 lymph node was higher than that of the patients with positive 6-2 lymph node (31.5% and 17.5%, P = 0.0032). There were no statistically significant differences in survival between subgroups of patients who had metastatic lymph node in the other 5 stations. The frequency of metastasis to other regional lymph nodes in patients with N2 perigastric lymph nodes was higher than that in patients with N1 perigastric lymph nodes.
Subdivision of the perigastric lymph nodes had little advantage. Elimination of the old system of classifying perigastric lymph nodes according to distance from the tumor is appropriate.
背景/目的：我们分析了根据与原发性胃癌的距离对胃周淋巴结分站转移的意义，以及国际抗癌联盟（UICC）肿瘤淋巴结转移（TNM）系统近期变化的适宜性。
对753例胃癌患者实施了胃切除术。根据日本分类法，将胃周淋巴结分为6站。根据与原发肿瘤的距离将其细分为2类：-1，距肿瘤边缘3 cm以内的淋巴结；-2，距肿瘤边缘超过3 cm的淋巴结。采用Kaplan-Meier法计算生存率，并用对数秩检验评估各组之间的差异。
胃周淋巴结细分站（编号为1-1至6-2）的转移频率在10.0%至41.1%之间。6-1淋巴结阳性患者的5年生存率高于6-2淋巴结阳性患者（31.5%和17.5%，P = 0.0032）。在其他5站有转移淋巴结的患者亚组之间，生存率无统计学显著差异。胃周淋巴结N2患者转移至其他区域淋巴结的频率高于胃周淋巴结N1患者。
胃周淋巴结细分优势不大。取消根据与肿瘤距离对胃周淋巴结进行分类的旧系统是合适的。
