中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2013年
4期
358-362
,共5页
耿宏智%刘兵%徐艺可%高华%迪力旦·纳斯尔
耿宏智%劉兵%徐藝可%高華%迪力旦·納斯爾
경굉지%류병%서예가%고화%적력단·납사이
胃肿瘤,进展期%淋巴结转移率%淋巴结分期%病理因素
胃腫瘤,進展期%淋巴結轉移率%淋巴結分期%病理因素
위종류,진전기%림파결전이솔%림파결분기%병리인소
Stomach neoplasms,advanced%Metastatic lymph nodes ratio%Lymph node staging%Pathologic factors
目的 探讨进展期胃癌淋巴结转移率(rN)分期和转移数量(pN)分期与病理因素的关系,为合理的胃癌分期提供依据.方法 回顾性分析2003年11月至2011年12月间新疆医科大学第一附属医院收治的555例进展期胃癌患者的临床病理资料,分析影响其rN分期和pN分期的病理因素.结果 单因素分析显示,分化程度、脉管内有无癌栓、肿瘤直径、大体形态和浸润深度与rN分期和pN分期均有关(P＜0.05)；组织学类型则与rN分期有关(P＜0.05),而与pN分期无关.Logistic回归分析显示,脉管内癌栓、肿瘤直径和浸润深度是进展期胃癌淋巴结转移的独立危险因素(均P＜0.05).ROC曲线显示,在评估进展期胃癌淋巴结转移分期的诊断价值上,rN分期和pN分期基本一致(P＞0.05).结论 无论是从淋巴结转移率还是从转移数量上看,脉管内癌栓、肿瘤直径和浸润深度都是进展期胃癌淋巴结转移的独立危险因素.rN分期对于评价进展期胃癌淋巴结转移分期在诊断价值上与pN分期一致.
目的 探討進展期胃癌淋巴結轉移率(rN)分期和轉移數量(pN)分期與病理因素的關繫,為閤理的胃癌分期提供依據.方法 迴顧性分析2003年11月至2011年12月間新疆醫科大學第一附屬醫院收治的555例進展期胃癌患者的臨床病理資料,分析影響其rN分期和pN分期的病理因素.結果 單因素分析顯示,分化程度、脈管內有無癌栓、腫瘤直徑、大體形態和浸潤深度與rN分期和pN分期均有關(P＜0.05)；組織學類型則與rN分期有關(P＜0.05),而與pN分期無關.Logistic迴歸分析顯示,脈管內癌栓、腫瘤直徑和浸潤深度是進展期胃癌淋巴結轉移的獨立危險因素(均P＜0.05).ROC麯線顯示,在評估進展期胃癌淋巴結轉移分期的診斷價值上,rN分期和pN分期基本一緻(P＞0.05).結論 無論是從淋巴結轉移率還是從轉移數量上看,脈管內癌栓、腫瘤直徑和浸潤深度都是進展期胃癌淋巴結轉移的獨立危險因素.rN分期對于評價進展期胃癌淋巴結轉移分期在診斷價值上與pN分期一緻.
목적 탐토진전기위암림파결전이솔(rN)분기화전이수량(pN)분기여병리인소적관계,위합리적위암분기제공의거.방법 회고성분석2003년11월지2011년12월간신강의과대학제일부속의원수치적555례진전기위암환자적림상병리자료,분석영향기rN분기화pN분기적병리인소.결과 단인소분석현시,분화정도、맥관내유무암전、종류직경、대체형태화침윤심도여rN분기화pN분기균유관(P＜0.05)；조직학류형칙여rN분기유관(P＜0.05),이여pN분기무관.Logistic회귀분석현시,맥관내암전、종류직경화침윤심도시진전기위암림파결전이적독립위험인소(균P＜0.05).ROC곡선현시,재평고진전기위암림파결전이분기적진단개치상,rN분기화pN분기기본일치(P＞0.05).결론 무론시종림파결전이솔환시종전이수량상간,맥관내암전、종류직경화침윤심도도시진전기위암림파결전이적독립위험인소.rN분기대우평개진전기위암림파결전이분기재진단개치상여pN분기일치.
Objective To explore the association of pathologic factors with the staging of metastatic lymph node ratio (rN) and metastatic lymph node number (pN),and to provide evidence for reasonable tumor staging in advanced gastric carcinoma (AGC).Methods The clinicopathological data of 555 patients,who received radical resection for primary tumor of AGC between November 2003 and December 2011 in The First Affiliated Hospital of Xinjiang Medical University,were reviewed retrospectively.The clinicopathological factors influencing rN and pN were analyzed.Results Univariate analysis showed that differentiation degree,vascular invasion,tumor diameter,gross type and invasion depth were significantly associated with rN or pN (all P＜0.05).Histological type was significantly associated with rN (P＜0.05),but not with pN.Logistic regression analysis revealed that vascular invasion,tumor diameter ≥4 cm and invasion depth were independent risk factors for lymph node distant metastasis in AGC (all P＜0.05).ROC curves showed that rN was consistent with pN in evaluating the diagnostic value of lymph node distant metastasis for tumor staging in AGC (P＞0.05).Conclusions Vascular invasion tumor diameter≥4 cm and invasion depth are independent risk factors for lymph node metastasis in AGC based on either metastatic lymph node ratio (rN) or metastatic lymph node number(pN).The rN staging is consistent with the pN staging in evaluating the diagnostic value of metastatic lymph node for tumor staging in AGC.
