Kitagawa Maki, Ichikawa Daisuke, Komatsu Shuhei, Okamoto Kazuma, Shiozaki Atsushi, Fujiwara Hitoshi, Kuriu Yoshiaki, Ikoma Hisashi, Nakanishi Masayoshi, Ochiai Toshiya, Kokuba Yukihito, Otsuji Eigo
Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Hepatogastroenterology. 2011 Nov-Dec;58(112):2148-51. doi: 10.5754/hge10078.
BACKGROUND/AIMS: The most critical problem of the numerical lymph node staging system is difficulty in evaluating preoperative staging. We investigated the directionality of metastatic lymph nodes as an alternative prognostic indicator of gastric cancer.
One hundred and seventy two patients who had undergone curative gastrectomy were examined. We divided the stations of lymph nodes into three zones according to the anatomical site. Then patients were classified into two groups according to the number of positive zones, unidirectional or multidirectional lymphatic spreading.
Seventy-five patients showed unidirectional lymphatic spreading, whereas 97 patients showed multidirectional. Logistic regression analysis showed that directionality correlated with the number of metastatic nodes. Directionality was found to be a significant prognostic factor on univariate analysis, but not on multivariate analysis.
The directionality could be a surrogate marker of total number of metastatic lymph nodes as a prognostic factor in patients with gastric cancer.
背景/目的：数字淋巴结分期系统最关键的问题在于术前分期评估困难。我们研究了转移性淋巴结的方向性，将其作为胃癌的一种替代预后指标。
对172例行根治性胃切除术的患者进行检查。我们根据淋巴结的解剖部位将其分站分为三个区域。然后根据阳性区域的数量、单向或多向淋巴扩散将患者分为两组。
75例患者表现为单向淋巴扩散，而97例患者表现为多向淋巴扩散。逻辑回归分析表明，方向性与转移淋巴结的数量相关。在单因素分析中，方向性被发现是一个显著的预后因素，但在多因素分析中并非如此。
方向性可作为转移性淋巴结总数的替代标志物，作为胃癌患者的预后因素。
