食管胃结合部腺癌淋巴结转移规律探索

目的探讨食管胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)的No.4d、5、6、12组淋巴结转移的规律和相关因素。方法回顾2015年6月至2018年5月北京大学肿瘤医院胃肠肿瘤中心一病区行全胃切除的AEG病人的临床及病理资料,分析胃下部淋巴引流区域淋巴结即No.4d、5、6、12组淋巴结的转移率,并分析各临床病理因素与其相关性,计数资料的组间比较采用χ^2检验,计量资料的组间比较采用两独立样本t检验。结果该研究共纳入77例病人,其中48例(62.33%)合并淋巴结转移,转移率较高的为No.3、1、7组淋巴结,分别为43.42%、22.08%、22.08%。No.4d、5、6、12组的淋巴结转移率分别为5.26%、3.90%、1.30%、1.37%,胃下部淋巴引流区域淋巴结整体的转移率为9.09%。对各临床病理因素的分析结果显示,仅病理T分期与胃下部淋巴引流区域淋巴结转移相关。结论单中心回顾性数据显示,AEG病人胃下部淋巴引流区域淋巴结整体转移率为9.09%,pT 4期为胃下部淋巴引流区域淋巴结转移的高危因素。

Exploration for the pattern of the lymph node metastasis of adenocarcinoma of esophagogastric junction

Objective To investigate the pattern and factors for lymph node metastasis of station 4d,5,6,12 for adenocarcinoma of esophagogastric junction.Methods A retrospective study was performed on the clinical and pathological data of AEG patients undergoing total gastrectomy from June 2015 to May 2018,analyzing the metastatic rate of the lymph nodes in the lymphatic drainage area of the lower stomach.Analysis of the factors for the metastasis was also performed,using chi-square test for categorical data and independent sample t test for continuous data.Results Of the 77 patients analyzed,48(62.33%)patients had positive lymph node metastasis,majorly in station 3,1 and 7,with metastatic rate of 43.42%,22.08%and 22.08%,respectively.The metastatic rates in station 4d,5,6 and 12 were 5.26%,3.90%,1.30%,1.37%and the overall metastatic rate of the lymph nodes in the lymphatic drainage area of the lower stomach was 9.09%,with which pathological T stage was the only associated factor among all the factors investigated.Conclusion The metastatic rate of the lymph nodes in the lymphatic drainage area of the lower stomach was 9.09%for AEG patients,of which pT 4.stage was the risk factor.