论文部分内容阅读
目的探讨胃癌淋巴结转移的规律。方法回顾我院1994年1月至2003年5月间608例胃癌术后病理资料,分析各组淋巴结的转移率,并用二值Logistic回归似然比法分析与第7～9组淋巴结转移相关的因素。结果本组608例中,第3组淋巴结转移率最高,为444%,其次为第15组的432%。第7、8、9组淋巴结转移率分别为372%、248%和207%,3组综合转移率为375%。与第7～9组淋巴结综合转移密切相关的因素有第1～6组淋巴结综合转移情况和肿瘤的浸润程度(P<005)。第7～9组淋巴结有转移时,预测第1～6组淋巴结有转移的准确率为822%,假阳性率为15%;第7～9组淋巴结无转移时,预测第10～16组淋巴结无转移的准确率为593%,假阳性率为127%。结论第7～9组淋巴结有类似前哨淋巴结的作用,术中病理活检有利于指导胃癌术式的选择。胃下部癌第7～9淋巴结有转移时宜常规清扫第15组淋巴结。
Objective To investigate the regularity of lymph node metastasis in gastric cancer. Methods The pathological data of 608 cases of gastric cancer from January 1994 to May 2003 in our hospital were retrospectively analyzed. The lymph node metastasis rate of each group was analyzed. Logistic regression likelihood ratio method was used to analyze the correlation with lymph node metastasis of group 7-9 factor. Results The group of 608 cases, the third group of lymph node metastasis rate was the highest, 444%, followed by the 15th group of 432%. The rates of lymph node metastasis in group 7, group 8, group 8 were 372%, 248% and 207%, respectively, and in group 3, the overall rate of metastasis was 375%. The factors closely related to the comprehensive metastasis of lymph nodes from group 7 to group 9 were the first to sixth group of lymph node metastasis and the degree of tumor infiltration (P <005). When there was metastasis of lymph nodes from group 7 to group 9, the accuracy of metastasis of group 1 to group 6 lymph nodes was predicted to be 822% and the false positive rate was 15%. When lymph nodes of group 7 to group 9 had no metastasis, lymph nodes from group 10 to group 16 The accuracy of non-metastasis was 593% and the false positive rate was 127%. Conclusions The lymph nodes in groups 7 to 9 have the similar effect of sentinel lymph node. Intraoperative pathological biopsy is helpful to guide the selection of gastric cancer. Gastric cancer in the first 7 to 9 lymph node metastasis should be routine dissection of the first 15 lymph nodes.