Adachi Y, Oshiro T, Okuyama T, Kamakura T, Mori M, Maehara Y, Sugimachi K
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am J Surg. 1995 Apr;169(4):382-5. doi: 10.1016/s0002-9610(99)80181-0.
Because insufficient lymph node examination can cause erroneous listing of earlier-nodal-stage gastric carcinoma (stage migration phenomenon), surgical results must be evaluated based on a highly accurate examination of the dissected lymph nodes. To establish a simple and useful classification of lymph node level, we analyzed the frequency and distribution of lymph node metastasis by using curatively treated node-positive gastric carcinoma.
Various clinicopathologic data were analyzed with reference to the degree of lymph node metastasis by using 240 patients with curatively resected node-positive gastric carcinoma. The cases were divided into the following three groups: 142 with positive level I (perigastric) nodes, 71 with positive level II (intermediate) nodes, and 27 with positive level III (distant) nodes, irrespective of the location of tumors.
The level of lymph node metastasis clearly correlated with the survival of patients, with the 5-year survival rates for level I, II, and III cases being 67%, 35%, and 26%, respectively (P < 0.01). The degree of lymph node metastasis was determined by the number of positive nodes (P < 0.01), the depth of invasion (P < 0.01), the size of tumors (P < 0.01), and the location of tumors (P < 0.05).
This simple classification of lymph node level (level I, II, and III) is useful for the evaluation and prediction of surgical results in gastric carcinoma.
由于淋巴结检查不充分可能导致早期淋巴结分期的胃癌错误分期（分期迁移现象），因此必须基于对切除淋巴结的高度准确检查来评估手术结果。为了建立一种简单且有用的淋巴结水平分类方法，我们使用接受根治性治疗的淋巴结阳性胃癌患者分析了淋巴结转移的频率和分布。
参考淋巴结转移程度，对240例接受根治性切除的淋巴结阳性胃癌患者的各种临床病理数据进行了分析。这些病例分为以下三组：142例I级（胃周）淋巴结阳性，71例II级（中间）淋巴结阳性，27例III级（远处）淋巴结阳性，不考虑肿瘤位置。
淋巴结转移水平与患者生存率明显相关，I级、II级和III级病例的5年生存率分别为67%、35%和26%（P<0.01）。淋巴结转移程度由阳性淋巴结数量（P<0.01）、浸润深度（P<0.01）、肿瘤大小（P<0.01）和肿瘤位置（P<0.05）决定。
这种简单的淋巴结水平分类（I级、II级和III级）有助于评估和预测胃癌的手术结果。
