胃癌病人淋巴浸润对于肿瘤生长和转移的可能性

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胃癌早期发现预后尚好,进展期胃癌预后较差.淋巴结、腹膜和肝转移发生率增加与癌细胞浸润深度相一致.日本福罔九州大学医院第二外科报道了进展性胃癌有浆膜浸润,在淋巴结浸润与癌细胞转移可能性两者之间的关系,特别是胃癌扩散中淋巴系统的作用.病人与方法:1965~1987年病理证实有浆膜浸润进展期胃癌324例,其中有淋巴浸润是214例.男153例,女61例.浆膜浸润183例,邻近组织和浆膜浸润或两者均有31例.血管浸润72例,淋巴结转移195例.行胃大部切除术100例,全胃切除114例.淋巴清除D_0和D_116例,D_2和D_3198例.术后常规随访有血液检查、胃肠道X线检查、内窥镜、CT和超声检查.可为单项和几项检查联合进行.术后随访第一年每3个月一次,然后间隔6~12个月一次.对53例胃癌组织用显微分光光度计测定DNA含量.以间质淋巴细胞DNA平均值作为正常二倍体染色体的对照量(2C),根据多倍体比例之多少DNA分布有4型:Ⅰ型<10%,90%以上细胞少于4C,散在细胞少于6C;Ⅱ型>10%,细胞大于4C和/或10%细胞比6C大;Ⅲ型10~20%,细胞比6C大; The prognosis of early detection of gastric cancer is still good, and the prognosis of advanced gastric cancer is poor. The increased incidence of lymph node, peritoneum and liver metastases is consistent with the depth of cancer cell infiltration. The second surgical department of Kyushu University Hospital in Kureha, Japan reported that there is serosal infiltration in advanced gastric cancer. The relationship between lymph node infiltration and the possibility of cancer metastasis, especially the role of the lymphatic system in the spread of gastric cancer. Patients and Methods: 324 to 1987 pathologically confirmed serosa invasive advanced gastric cancer in 324 cases, including lymph infiltration 214 cases. 153 males and 61 females. Serosal infiltration of 183 cases, adjacent tissues and serosa infiltration or both 31 cases. Invasive vascular in 72 cases, 195 cases of lymph node metastases. Subtotal gastrectomy in 100 cases, Total gastrectomy was performed in 114 cases. Dymphatic clearance was performed in D_0 and D_116 cases, D_2 and D_3198 cases. Postoperative routine follow-up included blood examination, gastrointestinal tract X-ray examination, endoscopy, CT, and ultrasonography. It was possible to combine single and several examinations. The patients were followed up every 3 months for the first year of follow-up, and then every 6 to 12 months. The DNA content was determined by microscopic spectrophotometry in 53 cases of gastric cancer. The mean value of the interstitial lymphocyte DNA was doubled. Body chromosome control amount (2C), root How much polyploid proportion of DNA distribution type 4: type I <10%, more than 90% of cells less than 4C, scattered cells less than 6C; type II> 10%, cells greater than 4C and/or 10% cells than 6C Type III 10 to 20%, cells larger than 6C;
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