CAJ | 학술논문

目的：探讨早期胃癌淋巴结转移阳性的淋巴结清扫范围对患者预后的影响。方法选择早期胃癌患者共129例，分为淋巴结转移阴性组（102例）和阳性组（27例），淋巴结清扫的方式包括D1和D2清扫术，收集所有纳入对象的临床病理资料并进行随访。结果除TNM分期外，淋巴结转移阴性组和阳性组在性别构成比、年龄、肿瘤直径、肿瘤部位、Borrmann分型、组织类型、分化程度方面均无统计学差异（ P ﹥0.05）。采用D2清扫术的早期胃癌患者生存率显著高于D1清扫术（ P ﹤0.05）。在淋巴结转移阳性的患者中，采用D2清扫术的患者生存时间显著高于D1清扫术（ P均﹤0.05）。在淋巴结转移阴性的患者中，D1清扫术和D2清扫术的患者中位生存时间无统计学差异（ P ﹥0.05）。结论早期胃癌在无法准确评估淋巴结转移情况时，应首选D2清扫术。
목적：탐토조기위암림파결전이양성적림파결청소범위대환자예후적영향。방법선택조기위암환자공129례，분위림파결전이음성조（102례）화양성조（27례），림파결청소적방식포괄D1화D2청소술，수집소유납입대상적림상병리자료병진행수방。결과제TNM분기외，림파결전이음성조화양성조재성별구성비、년령、종류직경、종류부위、Borrmann분형、조직류형、분화정도방면균무통계학차이（ P ﹥0.05）。채용D2청소술적조기위암환자생존솔현저고우D1청소술（ P ﹤0.05）。재림파결전이양성적환자중，채용D2청소술적환자생존시간현저고우D1청소술（ P균﹤0.05）。재림파결전이음성적환자중，D1청소술화D2청소술적환자중위생존시간무통계학차이（ P ﹥0.05）。결론조기위암재무법준학평고림파결전이정황시，응수선D2청소술。
Objective To investigate the effects of the extent of lymph node dissection on the prognosis of patients with early gastric canc-er and lymph node metastasis. Methods One hundred twenty-nine patients with early gastric cancer were divided into lymph node metastasis negative group(102 cases)and positive group(27 cases). The methods of lymph node dissection included D1 and D2 dissection. All clinical da-ta of subjects were collected and followed-up. Results Except TNM stage,there were no statistically significant differences in gender,age, tumor size,tumor location,Borrmann type,histological type,degree of differentiation between two groups( P ﹥0. 05). Survival rate of patients with early gastric cancer using D2 dissection was significantly higher than D1 dissection( P ﹤0. 05). In patients with positive lymph node metas-tasis,survival time in D2 dissection was significantly longer than D1 dissection( P ﹤0. 05). In patients with negative lymph node metastasis,no significant difference was found in median survival time between D1 and D2 dissection( P ﹥0. 05). Conclusion If lymph node metastasis can-not be accurately assessed in early gastric cancer,we should prefer D2 dissection.