淋巴结转移指数及胃癌临床病理特征相关性探究.docVIP

淋巴结转移指数及胃癌临床病理特征相关性探究??【摘要】 目的 探讨淋巴结转移指数与胃癌的临床病理特征的相关性, 建立一个以淋巴结转移指数预测胃癌N分期的评分系统,为手术者选择合理的淋巴结切除范围提供一定帮助。方法 回顾性分析216例胃癌患者的淋巴结转移和临床病理特征之间的相关性,单因素和多因素分析筛选出影响实际淋巴转移病理分期水平高低的临床参数,赋予各参数不同的计分分值。绘制接受者工作特征曲线,确定预测各淋巴结转移病理分期的评分标准。结果 单因素分析显示不同肿瘤部位、大小、浸润深度、组织学类型的淋巴结转移病理分期差异具有统计学意义;早期胃癌与进展期胃癌淋巴结转移病理分期的差异具有统计学意义, 但多因素分析结果显示肿瘤大小、浸润深度、组织学类型是淋巴结转移病理分期的独立影响因素。结论 淋巴结转移指数能更加全面反映胃癌的淋巴结转移情况,是定义胃癌淋巴结转移病理分期的较好方法。? 【关键词】 胃癌;淋巴结转移指数;病理 ?? The Relationship Between index of the lymph node metastasis and gastric cancer clinicopathologic character ZOU Jin-lin,LIN Zhen-dong,BIAN Zhuang. Department of General Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, 519000,China 【Abstract】 Objective To explore the relationship between index of the lymph node metastasis and gastric cancer clinicopathologic character and to establish a preoper- ative scoring system of metastases (N) in gastric cancers to predict the lymph node to offer avail for resect scope of lymph node. Methods The clinicopathologic data of 216 cases with gastric cancer were analyzed retrospectively. The factors influencing significantly actual lymph node status (NX) were selected through the univariate and the multivar- iate analysis, and the score of each factor was identified. Scores predicting different N stages were identified using receiver operating characterastic curves. Results Tumor size, depth of invasion and histopathological types were selected to establish the scoring system.There were signifficant difference about NX in different tumor size,depth of invasion and histopathologican types by on way analysis of variance.Conclusion The index of the lymph node metastasis can response the actual lymph node status. It was a better measure to define the lymph node metastases of gastric cancers. ? 【Key words】 Stomach neoplasms; index of the lymph node metastasis ? 关于胃癌淋巴结转移的N1、N2、N3的定义存在不一致性,给临床医生对胃癌的分期、治疗缺乏统一标准,研究所得出的结论也缺乏科学的可比性。目前存在的关于N的分期都存在局限性,为了更合理兼顾转移的数量和距离,我们提出淋巴结转移