Park Hee Sun, Kim Young Jun, Ko Su Yeon, Yoo Moon-Won, Lee Kyung Yung, Jung Sung-Il, Jeon Hae Jeong
Department of Radiology, Konkuk University School of Medicine, Seoul, Korea.
Acta Radiol. 2012 Jun 1;53(5):501-7. doi: 10.1258/ar.2012.120054. Epub 2012 May 9.
Benign regional lymph nodes (LNs) are sometimes enlarged in gastric cancer patients due to reactive or inflammatory changes. Frequently these enlarged LNs can mimic LN metastasis and lead to overstaging.
To assess frequency of benign regional LNs in gastric cancer patients compared with that in a healthy population and to assess the frequency of benign regional LNs in gastric cancer according to T-staging.
Between August 2005 and June 2009, 177 patients with surgically proven gastric cancer without LN metastasis (TanyN0M0) who had previously undergone preoperative multidetector row CT (MDCT) and 168 healthy patients who visited the healthcare center and underwent an abdominal MDCT were included in this retrospective study. An abdominal radiologist evaluated the distribution of regional LNs and measured the short diameter of LNs ≥6 mm, ≥8 mm, and ≥10 mm. The number of enlarged benign LNs was compared between the two groups, and the distribution of LN with regard to T-stage of gastric cancer was also evaluated.
At least one LN ≥6 mm, ≥8 mm, and ≥10 mm was detected in 64.4% (114/177), 22.0% (39/177), and 4.0% (7/177) of patients in the gastric cancer group, respectively, compared to 29.8% (50/168), 4.2% (7/168), and 0% of patients in the healthy group, respectively. The difference between the two groups was statistically significant (P <0.0001). The LN ≥8 mm was found in 14.9% (20/134) in early gastric cancer (T1), and 44.2% (19/43) in advanced cancer (T2 or higher); the difference was statistically significant (P = 0.0002). However, the frequency of LN ≥6 mm in mucosal cancer (T1a) and submucosal cancer (T2b) was not significantly different, regardless of its size.
Benign regional LNs ≥6 mm are more frequently detected in gastric cancer patients than in a healthy population and in advanced gastric cancer than in early cancer.
胃癌患者的良性区域淋巴结有时会因反应性或炎症性改变而肿大。这些肿大的淋巴结常常会被误诊为淋巴结转移，从而导致分期过度。
评估胃癌患者与健康人群中良性区域淋巴结的出现频率，并根据T分期评估胃癌中良性区域淋巴结的出现频率。
本回顾性研究纳入了2005年8月至2009年6月期间177例经手术证实无淋巴结转移（任何T期N0M0）且术前接受过多层螺旋CT（MDCT）检查的胃癌患者，以及168例到医疗中心就诊并接受腹部MDCT检查的健康患者。一名腹部放射科医生评估区域淋巴结的分布，并测量直径≥6 mm、≥8 mm和≥10 mm淋巴结的短径。比较两组中肿大良性淋巴结的数量，并评估胃癌T分期中淋巴结的分布情况。
胃癌组中分别有64.4%（114/177）、22.0%（39/177）和4.0%（7/177）的患者检测到至少一个直径≥6 mm、≥8 mm和≥10 mm的淋巴结，而健康组中分别为29.8%（50/168）、4.2%（7/168）和0%。两组之间的差异具有统计学意义（P<0.0001）。早期胃癌（T1）中直径≥8 mm的淋巴结占14.9%（20/134），进展期癌（T2及以上）中占44.2%（19/43）；差异具有统计学意义（P = 0.0002）。然而，黏膜癌（T1a）和黏膜下癌（T2b）中直径≥6 mm淋巴结的出现频率，无论其大小，均无显著差异。
与健康人群相比，胃癌患者中更容易检测到直径≥6 mm的良性区域淋巴结，与早期胃癌相比，进展期胃癌中更容易检测到。
