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1、淋巴结转移阴性的胃癌患者临床病理特征及生存分析23O2006年5月第9卷第3期ChinJGestrointestSurg,May2006,Vol9,No.3淋巴结转移阴性的胃癌患者临床病理特征及生存分析黎剑蔡世荣何裕隆黄美近董文广梅开勇汪建平詹文华【摘要】目的探讨常规病理检查淋巴结转移阴性(pN0)胃癌患者的预后.方法回顾性分析87例pN0胃癌患者的临床病理特征与生存率的关系.结果全组患者男性79.3%,女性20.7%;超过6o岁者占44.8%.26.4%的肿瘤位于上部(u),23.0%在中部(M),51.4%位于下部(L).肿瘤小于或等于2cm者29.9%,2—5c
2、m者57.5%,大于或等于5cm者12.6%.Dz式淋巴结清扫86.2%,D3式(包括D,式)淋巴结清扫13.8%.远端胃切除67.8%,近端胃切除4.6%.全胃切除27.6%.57.5%的患者术中输血.23例(26.4%)患者术后接受化疗.全组患者5年生存率56.5%.是否术后化疗,不同pT分级,有无淋巴管和血管浸润患者问的生存率比较,P<0.05;差异有统计学意义.病理分级中的T分级增加是危险因子.术后化疗是保护因子.结论为提高pN0胃癌患者5年生存率,需选择合适的术后化疗.【关键词】胃肿瘤;病理学.临床;预后Clinicopathologicfeature
3、softhepatientswithnode-negativemetastasisgastricadenocarcinomaandtheirsurvivalanalysisLIJian,CAIShi—rong,HEYu-long,HUANGMei-jin,MEIKal-yong,WANGJian-ping,ZHANWen-DepartmentofGastroizttestinopancreaticSurgery,TheFirstAJ~diatedHospital,SunYet—sergUniversity,Guangzhou510080,ChinaCorrespond
4、ingauthor:ZHANWen—Jllm.E-mail:wenhuazh@2Jc几corn[Abstract】ObjectiveToinvestigatetheelinicopathologiefeaturesofthepafien~withnode-negativemetastasis(pN0)gastriccarcinomaconfirmedbyroutinepathologicexamination(H&Es~uins),andtheirrelationshipwithsurviva1.MethodsTheelinico-pathologicdata
5、of87pN0gastriccarcinomapatien~wereanalyzedretrospectively.Kaplan-Meier(Log—rank)methodWasusedtocomparethesurvivalrate,andCoxregressionmethodWasusedtoscreentheindependentprognosisfactorsforpN0gastriccancer.ResultsTherewere69malesand18femals.D2lymphadeneetomyWasperformedin75(86.2%),andD3i
6、n13cases(13.8%).DistalgastreetomyWasperformedin59(67.8%).totalgestrectomyin24(27.6%)andproximalgastreetomyin14cases(4.6%).Twen~-three(26.4%)cssesreceived?postoperativechemotherapyand64(73.6%)didnot.The5-yearsurvivalrateofthe87pNOgastriccarcinomapatien~Was56.5%.Therewerenodifferencesinsu
7、rvivalrateconsideringage,tumorlocation,gastrectomy,lymphnodesdissection,differentiationgrade,andtumor-stromarelationship(P>0.05),whilethedifferencesweresignificantinsurvivalratebetweenthepatien~withpostoperativechemotherapy.lymphaticinvasion,venousinvasionornot,anddifferentp
