Wu C W, Hsieh M C, Tsay S H, Lui W Y, P'eng F K
Department of Surgery, Veterans General Hospital-Taipei, Taiwan, Republic of China.
J Clin Gastroenterol. 1994 Oct;19(3):259-63.
A detailed clinical and anatomic-pathological study of lymph node (LN) metastases from adenocarcinoma of the midstomach is lacking. To such an end, we prospectively evaluated 100 patients who underwent radical gastrectomy. A total of 3,394 LNs were removed with an average of 34 per specimen (range, 10-105). Forty-seven patients (47%) had involved LNs. The most frequent LNs involved were those along the lesser curvature (38%), greater curvature (23%), left gastric artery (19%), infrapyloric (16%), above the common hepatic artery (13%), suprapyloric (11%), and right paracardia (9%). When tumors involved the upper stomach, the frequency of LN metastases along the splenic artery and in the splenic hilum was 11.8%. Tumors along the lesser curvature or on the anterior or posterior walls had splenic hilar LN metastases in 10%, whereas of tumors involving the whole circumference, 16.7% showed with metastases. Four of 33 patients (12.1%) with early cancer had LN metastasis confined to the perigastric, left gastric artery, and above the common hepatic artery. The LN metastases were closely related to the depth of cancer invasion, location, size, gross appearance, and histology of the tumor.
目前缺乏对胃中部腺癌淋巴结（LN）转移的详细临床及解剖病理学研究。为此，我们对100例行根治性胃切除术的患者进行了前瞻性评估。共切除3394枚淋巴结，每个标本平均34枚（范围10 - 105枚）。47例患者（47%）有淋巴结受累。最常受累的淋巴结是沿小弯侧（38%）、大弯侧（23%）、胃左动脉（19%）、幽门下（16%）、肝总动脉上方（13%）、幽门上（11%）和贲门右旁（9%）的淋巴结。当肿瘤累及胃上部时，脾动脉及脾门处淋巴结转移率为11.8%。沿小弯侧或位于前壁或后壁的肿瘤，脾门淋巴结转移率为10%，而累及全周的肿瘤，16.7%有转移。33例早期癌患者中有4例（12.1%）的淋巴结转移局限于胃周、胃左动脉及肝总动脉上方。淋巴结转移与肿瘤的浸润深度、位置、大小、大体外观及组织学密切相关。
