CAJ | 학술논문

目的探讨进展期远端胃癌淋巴结3站转移率，以规范化指导D2、D2+根治术中淋巴结清扫的正确方法.方法回顾性总结2003年1月~2011年1月期间我院收治的进展期远端胃癌患者62例，分析其淋巴结转移特点及其D2、D2+根治术手术关联.结果存有第Ⅰ站淋巴结转移例数49例，占79.03%；第Ⅱ站淋巴结转移例数17例，占27.42%.肿瘤的胃壁浸润深度pT、区域淋巴结转移站数及pN个数和Borrmann分型成为重要的预后指标，中pT、pN最为重要；全组病人3年总生存率为56.45%(35/62)，死亡27例，其中pT4、pT3、pN3、pN2、BorrmannⅢ、Ⅳ型病人占绝对大多数.结论进展期远端胃癌外科治疗以D2淋巴结清扫范围较合理，随着pT、pN分期偏晚，区域淋巴结转移站数和个数依次增加，其预后一定出现渐差的趋势.其次须权衡利弊，谨慎把握D2+PAND.
목적탐토진전기원단위암림파결3참전이솔，이규범화지도D2、D2+근치술중림파결청소적정학방법.방법회고성총결2003년1월~2011년1월기간아원수치적진전기원단위암환자62례，분석기림파결전이특점급기D2、D2+근치술수술관련.결과존유제Ⅰ참림파결전이례수49례，점79.03%；제Ⅱ참림파결전이례수17례，점27.42%.종류적위벽침윤심도pT、구역림파결전이참수급pN개수화Borrmann분형성위중요적예후지표，중pT、pN최위중요；전조병인3년총생존솔위56.45%(35/62)，사망27례，기중pT4、pT3、pN3、pN2、BorrmannⅢ、Ⅳ형병인점절대대다수.결론진전기원단위암외과치료이D2림파결청소범위교합리，수착pT、pN분기편만，구역림파결전이참수화개수의차증가，기예후일정출현점차적추세.기차수권형리폐，근신파악D2+PAND.
Objective 3 stations in advanced distal gastric cancer lymph node metastasis rate, to standardized guidance D2, D2+ lymph node dissection for radical resection of the correct way. Methods A retrospective summary of January 2003 to January 2011, 62 cases with advanced distal gastric cancer patients in our hospital, analysis of the characteristics of lymph node metastasis and D2, D2+ radical mastectomy surgery associated. Results There first Ⅰ station lymph node metastasis in cases of the 49 cases, accounting for 79.03%; station Ⅱ lymph node metastasis in cases of the 17 cases, accounting for 27.42 percent. Gastric wall invasion depth of tumor pT, lymph node metastasis the number of stations and number of pN and Borrmann type to become an important prognostic indicator in the pT, pN and the most important; 3-year overall survival of all patients was 56.45% (35/62) 27 cases of death, and pT4, pT3 in which pN3, pN2, Borrmann Ⅲ, Ⅳ patients accounted for an absolute majority.Conclusion advanced remote surgical treatment of gastric cancer with D2 lymph node dissection than is reasonable, along with the pT, pN partial installments late, regional lymph node stations and in turn increase the number of its prognosis must become worse trend. Required to weigh the pros and cons again, hold it carefully and D2+ PAND indications.