| Objective:To summarize the clinicopathological features of adenocarcinoma of the esophagogastric junction and analyze the regularity of lymph node metastasis around it,so as to provide reference for the scope of lymph node dissection during clinical operation.Methods:Selection of tumor hospital of Shanxi Province in July 2014 to May 2018 treated during the period of the clinical data of 350 patients with cardia cancer and disease inspection results,analysis,by studying lymph node metastasis and the diameter of the local tumor,differentiation degree,infiltration depth of the relationship between clinical pathological characteristics,such as the stomach,to explore the value of the third leg of lymph node cleaning in cardia cancer radical.The discharged patients were followed up and observed through outpatient reexamination,telephone contact and other methods until January 2019.Results:1.Among the enrolled patients,there were 293 males and 57 females,male to female ratio: 5.14:1,age: 36-82,average age: 61.57 years old.2.A total of 6,718 lymph nodes were dissection in the 350 patients with esophageal and gastric junction adenocarcinoma,among which 1,613 lymph nodes were metastatic,with a metastasis rate of 24.01%.3.The metastatic status of peripheral lymph nodes in each group: the first station: group1(24.41%),group 2(25.75%),group 3(29.74%),4SA(20.44%),4SB(19.88%),the second station: Group 4(12.32%),Group 7(23.21%),Group 8A(8.62%),Group 9 (23.97%),Group 10(19.15%),Group 11P(17.43%),Group 11D(16.0%),the third stop:Group 5(17.11%),Group 6(11.30%),Group 8P(6.98%),Group 12AB(8.89%),Group16AB(7.5%).4.The rate of lymph node metastasis in the third station was closely related to the longest diameter of the tumor body,the depth of tumor invasion into the gastric wall and the degree of differentiation of the tumor itself,but had no obvious correlation with the age,gender,weight of the patient and the presence of complications.5.The analysis showed that the incidence of peripheral lymph node metastasis was significantly increased with the increasing depth of tumor invasion into the gastric wall(P<0.05);When the longest diameter of the tumor body was ≧4cm,the probability of metastasis of surrounding lymph nodes was increased,with statistical significance(P<0.05).The lymph node metastasis rate was 83.1% in the low-differentiation group and 58.4% in the medium-high differentiation group,and the difference was statistically significant(P<0.05).Conclusion:1.The depth of tumor invasion into the stomach,the longest diameter of the tumor and the degree of tumor differentiation are independent risk factors for lymph node metastasis in AEG patients.2.For cardia cancer Siewert type 1 patients in the surgery treatment,should be thoroughly cleaning the lower segment esophageal around and around the mediastinal lymph nodes,abdominal then you need to focus on cleaning the group 1,2,3 in group a,3 b group and the group of 7 lymph nodes,the rest of the group whether lymph node cleaning needs according to whether intraoperative probe swollen lymph nodes.3.For type II and III patients,total gastrectomy and D2 lymph node dissection were recommended when the tumor invaded the whole layer of the gastric wall,the longest diameter of the tumor ≥ 4cm,and the degree of pathological differentiation was low. |
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