[无浆膜侵犯的胃癌的淋巴结转移与预后]

[Lymph node metastasis and prognosis of gastric cancer without serosal invasion].

作者信息

Hu Xiang, Cao Liang, Yu Yi

机构信息

Department of General Surgery, Dalian Medical University, Dalian, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Feb;15(2):133-6.

PMID:22368018

Abstract

OBJECTIVE

To evaluate the impact of lymph node metastasis on the prognosis of gastric cancer without serosal invasion.

METHODS

From January 1994 to December 2005, 616 gastric cancer patients without serosal invasion and 162 gastric cancer patients with serosal invasion underwent D2 or D2(+) lymphadenectomy. Clinicopathologic data and long-term survival of the two groups were analyzed retrospectively.

RESULTS

The 5-year survival rate of patients with gastric cancer without serosal invasion was 77.9%, significantly higher than that of patients with gastric cancer with serosal invasion (37.3%) (P<0.01). The 5-year survival rates of T1a(M), T1b(SM), T2(MP), T3(SS), T4(SE,SI) were 95.6%, 92.5%, 73.5%, 62.7%, and 37.3%, respectively. As classified in the 13th edition of Gastric Cancer Treatment Guidelines in Japan, the 5-year survival rates of patients with gastric cancer without serosal invasion were 91.5% in N0, 75.3% in N1, 54.8% in N2, 14.7% in N3, and the differences were statistically significant (P<0.01). According to 7th edition of TNM classification, the 5-year survival rates of N0, N1, N2, N3a, N3b for the study group were 91.5%, 83.6%, 59.8%, 17.2%, 11.8%, respectively (P<0.01). Lymph node metastasis was an independent prognostic risk factor (P<0.01).

CONCLUSIONS

In patients with gastric cancer without serosal invasion, lymph node metastasis is an predictive factor regardless it is based on the extent or the number of lymph node metastasis.

摘要

目的

评估淋巴结转移对无浆膜侵犯的胃癌患者预后的影响。

方法

1994年1月至2005年12月，616例无浆膜侵犯的胃癌患者和162例有浆膜侵犯的胃癌患者接受了D2或D2（+）淋巴结清扫术。回顾性分析两组患者的临床病理资料和长期生存情况。

结果

无浆膜侵犯的胃癌患者5年生存率为77.9%，显著高于有浆膜侵犯的胃癌患者（37.3%）（P<0.01）。T1a（M）、T1b（SM）、T2（MP）、T3（SS）、T4（SE，SI）患者的5年生存率分别为95.6%、92.5%、73.5%、62.7%和37.3%。根据日本《胃癌治疗指南》第13版分类，无浆膜侵犯的胃癌患者N0期5年生存率为91.5%，N1期为75.3%，N2期为54.8%，N3期为14.7%，差异有统计学意义（P<0.01）。根据第7版TNM分类，研究组N0、N1、N2、N3a、N3b患者的5年生存率分别为91.5%、83.6%、59.8%、17.2%、11.8%（P<0.01）。淋巴结转移是独立的预后危险因素（P<0.01）。