Kim Dong Jin, Kim Wook
Department of Surgery, The Catholic University of Korea St. Paul's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Department of Surgery, The Catholic University of Korea Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
J Gastric Cancer. 2018 Mar;18(1):20-29. doi: 10.5230/jgc.2018.18.e1. Epub 2017 Dec 12.
Pre-operative lymph node (LN) size is a valuable parameter for determining treatment strategy for gastric cancer. However, a correlation between LN size and metastasis has not been established.
Thirty-six LN-positive (LNP) and matched 36 LN-negative (LNN) patients were included, and pathology slides of the LNs of these patients were reviewed. All the LNs were measured along the long-axis (LA) and short-axis (SA), manually.
Average retrieved LNs were 37.3±19.8 and 40.5±11.6 in the LNN and LNP groups, respectively. In total 2,800 LNs, including 136 metastatic LNs (MLNs) and 2,664 non-metastatic LNs (nMLNs), were evaluated. Mean length was significantly more in MLNs along both, the LA and SA (MLN_LA vs. nMLN_LA: 4.97±3.84 vs. 3.37±2.40 mm, MLN_SA vs. nMLN_SA: 3.86±3.19 vs. 2.43±1.59 mm; P<0.001). However, 92.6% (126/136) and 95.6% (130/136) of MLNs were <10 mm along the LA and SA, respectively. In addition, only 22.2% of the LNP group exhibited an MLN as the largest LN.
Pre-operative multi-detector computed tomography has limited ability in estimating the presence of metastasis in LNs because most MLNs are less than 10 mm, and only a small proportion of the LNP group exhibits an MLN as the largest MLN.
术前淋巴结（LN）大小是确定胃癌治疗策略的一个重要参数。然而，LN大小与转移之间的相关性尚未确立。
纳入36例淋巴结阳性（LNP）患者及36例配对的淋巴结阴性（LNN）患者，并对这些患者的淋巴结病理切片进行回顾。所有淋巴结均沿长轴（LA）和短轴（SA）进行手动测量。
LNN组和LNP组平均回收的淋巴结分别为37.3±19.8个和40.5±11.6个。共评估了2800个淋巴结，其中包括136个转移淋巴结（MLN）和2664个非转移淋巴结（nMLN）。MLN沿LA和SA的平均长度均显著更长（MLN_LA与nMLN_LA：4.97±3.84 vs. 3.37±2.40mm，MLN_SA与nMLN_SA：3.86±3.19 vs. 2.43±1.59mm；P<0.001）。然而，分别有92.6%（126/136）和95.6%（130/136）的MLN沿LA和SA小于10mm。此外，LNP组中只有22.2%的患者最大的淋巴结为MLN。
术前多排螺旋计算机断层扫描在评估淋巴结转移情况方面能力有限，因为大多数MLN小于10mm，且LNP组中只有一小部分患者最大的淋巴结为MLN。
