Adachi Y, Mori M, Maehara Y, Kitano S, Sugimachi K
First Department of Surgery, Oita Medical University, Japan.
J Am Coll Surg. 1997 Apr;184(4):373-7.
The presence or absence of lymph node metastasis closely correlates with survival of patients with gastric carcinoma. Although prognostic significance of the number and level of lymph node metastasis has been clarified, clinicopathologic features and prognostic indicators of node-negative gastric carcinoma have not yet been studied.
The records of 435 patients who underwent curative D2 or D3 gastrectomy for gastric carcinoma between 1977 and 1987 were analyzed retrospectively. Clinicopathologic data of 252 patients having no lymph node metastasis were compared with those of 183 patients with lymph node metastasis. Prognostic factors were investigated by univariate and multivariate analyses.
Compared with node-positive cases, node-negative cases were characterized by frequent location in the lower two thirds of the stomach (85 percent), tumor size less than 4 cm (54 percent), grossly superficial type (69 percent), and tumor invasion not beyond the muscularis propria (77 percent). The 10-year-survival rate for patients with node-negative tumors was 93.4 percent. Multivariate analysis demonstrated that depth of wall invasion and age of patient were independent prognostic factors.
Node-negative gastric carcinoma is associated with a favorable outcome because of small progression of the disease. The depth of wall invasion and patient age were the most important prognostic factors.
淋巴结转移的有无与胃癌患者的生存率密切相关。虽然淋巴结转移的数量和程度的预后意义已得到阐明，但对无淋巴结转移的胃癌的临床病理特征和预后指标尚未进行研究。
回顾性分析了1977年至1987年间435例行根治性D2或D3胃癌切除术患者的记录。将252例无淋巴结转移患者的临床病理数据与183例有淋巴结转移患者的临床病理数据进行了比较。通过单因素和多因素分析研究预后因素。
与有淋巴结转移的病例相比，无淋巴结转移的病例的特点是肿瘤多位于胃的下三分之二（85%），肿瘤大小小于4cm（54%），大体为浅表型（69%），肿瘤浸润未超出固有肌层（77%）。无淋巴结转移肿瘤患者的10年生存率为93.4%。多因素分析表明，壁层浸润深度和患者年龄是独立的预后因素。
无淋巴结转移的胃癌由于疾病进展较小，预后良好。壁层浸润深度和患者年龄是最重要的预后因素。
