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目的初步研究区域性淋巴结反应性增生对胃癌患者术后复发及生存状态的影响。方法回顾性分析2007年1月至2009年7月期间铜陵市人民医院胃肠外科因胃癌实施国际标准化D2手术并进行术后跟踪随访患者的临床资料。根据患者术后病理检出反应性增生性淋巴结的数量,采用中位数法将随访病例分为增生组(n=18)及非增生组(n=43),采用Kaplan-Meier和log-rank法比较2组患者术后5年累积无病生存率及5年累积总生存率。结果 2组患者在年龄、性别、术后病理分期、手术方式、手术范围及术后化疗方案方面的差异均无统计学意义(P>0.05)。增生组患者的中位无病生存时间为50个月,非增生组患者的中位无病生存时间为39个月,log-rank检验比较增生组患者的5年累积无病生存率明显高于非增生组患者(66.7%比34.9%,P=0.048)。增生组和非增生组患者的中位生存时间分别为53.6个月和52.3个月,术后5年累积总生存率差异无统计学意义(72.2%比60.5%,P=0.338)。结论区域性淋巴结反应性增生一定程度上反应了胃癌患者肿瘤免疫的程度,与术后5年无病生存率有明显的相关性。
Objective To study the effect of regional lymph node reactive hyperplasia on the recurrence and survival of gastric cancer patients. Methods The clinical data of patients with gastric cancer who underwent D2 international standard surgery and follow-up follow-up were retrospectively analyzed from January 2007 to July 2009 in Tongling People’s Hospital. According to the postoperative pathological findings of reactive hyperplastic lymph nodes, the follow-up cases were divided into hyperplasia group (n = 18) and non-hyperplastic group (n = 43) by median method. Kaplan-Meier and log-rank The two groups of patients after 5-year cumulative disease-free survival rate and 5-year cumulative total survival rate. Results There was no significant difference in age, sex, pathological stage, operation mode, operation scope and postoperative chemotherapy regimen between the two groups (P> 0.05). The median disease-free survival time was 50 months in the hyperplastic group and 39 months in the non-hyperplastic group. The 5-year cumulative disease-free survival of patients in the hyperplastic group was significantly higher than that in the log-rank test Patients in the non-proliferative group (66.7% vs 34.9%, P = 0.048). The median survival time was 53.6 months and 52.3 months in the proliferative and non-proliferative groups, respectively. There was no significant difference in cumulative 5-year cumulative survival between the two groups (72.2% vs. 60.5%, P = 0.338). Conclusions The regional lymph node hyperplasia reflects the degree of tumor immunity in gastric cancer patients to a certain extent, and has a clear correlation with the 5-year disease-free survival rate after operation.