胃腺癌中淋巴结评估不足。

Insufficient lymph node assessment in gastric adenocarcinoma.

作者信息

Khanjani Nezhat, Mirzaei Sepideh, Nasrolahi Hamid, Hamedi Seyed Hasan, Mosalaei Ahmad, Omidvari Shapour, Ahmadloo Niloofar, Ansari Mansour, Sobhani Fatemeh, Mohammadianpanah Mohammad

机构信息

Department of Radiation Oncology, Shiraz University of Medical Sciences, Shiraz, Iran.

Shiraz Institute for Cancer Research, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

J Egypt Natl Canc Inst. 2019 Oct 22;31(1):2. doi: 10.1186/s43046-019-0004-1.

DOI:10.1186/s43046-019-0004-1

PMID:32372269

Abstract

BACKGROUND

This study aimed to investigate the sufficient (≥ 16) lymph node assessment in 449 patients with gastric adenocarcinoma and literature review.

METHODS

Four hundred and forty-nine patients with pathologically confirmed locoregional invasive gastric adenocarcinoma from 2004 to 2013 were included. A standard surgical resection was performed for all the patients with (n = 16) or without (n = 433) neoadjuvant treatment.

RESULTS

In this study, 301 men and 148 women with a median age of 58 (range 21-88) years were included. The median total numbers of examined lymph nodes were 9 (range 0-55). Ninety-five patients (21.2%) had adequate (≥ 16) lymph node examination, and 70 patients (15.6%) had no examined lymph nodes. In univariate analysis, total or near total gastrectomy (P < 0.001), advanced node stage (P < 0.001), primary tumor size > 6 cm (P < 0.001), and the presence of perineural invasion (P = 0.039) were associated with more average number of examined lymph nodes. On multivariate analysis, node stage (P < 0.001) and type of surgery (P = 0.008) were independent predictive factors.

CONCLUSION

In this study, approximately one in five patients with gastric adenocarcinoma had sufficient lymph node assessment. More studies are suggested for identifying a true inadequate lymph node dissection from insufficient lymph node assessment.

摘要

背景

本研究旨在调查449例胃腺癌患者的充分（≥16个）淋巴结评估情况并进行文献综述。

方法

纳入2004年至2013年449例经病理证实为局部浸润性胃腺癌的患者。所有患者均接受了标准手术切除，其中部分患者（n = 16）接受了新辅助治疗，部分患者（n = 433）未接受新辅助治疗。

结果

本研究纳入了301例男性和148例女性，中位年龄为58岁（范围21 - 88岁）。检查的淋巴结总数中位数为9个（范围0 - 55个）。95例患者（21.2%）进行了充分（≥16个）的淋巴结检查，70例患者（15.6%）未进行淋巴结检查。单因素分析显示，全胃或近全胃切除术（P < 0.001）、晚期淋巴结分期（P < 0.001）、原发肿瘤大小> 6 cm（P < 0.001）以及存在神经周围侵犯（P = 0.039）与检查的淋巴结平均数量较多相关。多因素分析显示，淋巴结分期（P < 0.001）和手术类型（P = 0.008）是独立的预测因素。