Matsumoto H, Yonemura Y, Segawa M, Kosaka T, Yamaguchi A, Miwa K, Miyazaki I
Second Department of Surgery, School of Medicine, Kanazawa University, Japan.
Nihon Geka Gakkai Zasshi. 1991 Jul;92(7):820-4.
Para-aortic lymph nodes (No. 16) from 21 patients with advanced gastric cancer who underwent extensive lymph node dissection, were sliced consecutively at intervals of 50 mu to study minute metastasis of No. 16 lymph nodes. Twenty-six of 30 metastatic lymph nodes had minute involvement, in which carcinoma cells were detected in marginal sinus of lymph node, microscopically. The rate of the metastases to No. 16 lymph nodes was 19% among N0-3 cases by conventional method (not consecutive slices). On the contrary, the percentage of metastasis to No. 16 lymph nodes by consecutive slices was 33% among N0-3 cases. Therefore, No. 16 nodes are involved in metastasis at high rate at operation and the extensive lymph node dissection including No. 16 nodes (R4) will be recommended to prevent lymph node recurrence caused by such a minute metastasis.
对21例行广泛淋巴结清扫术的进展期胃癌患者的腹主动脉旁淋巴结（第16组），以50μm的间隔连续切片，研究第16组淋巴结的微小转移情况。30个转移淋巴结中有26个有微小转移，镜下可见癌细胞位于淋巴结边缘窦。按传统方法（非连续切片），N0 - 3期病例中第16组淋巴结转移率为19%。相反，连续切片时N0 - 3期病例中第16组淋巴结转移率为33%。因此，第16组淋巴结在手术时转移率较高，建议行包括第16组淋巴结的广泛淋巴结清扫术（R4）以预防由这种微小转移导致的淋巴结复发。
