| Objective: In the worldwide clinic, gastric cancer is one of the most commonmalignancies. It is reported that in the worldwide the mortality rate of the patients withgastric carcinoma ranks second in the malignancy and while the patients in China ranksfirst in the malignant tumor. There are a variety of treatments for gastric cancer, butsurgical removal is still the only conservative treatment which is recognized by theworld. The key of modern surgical treatment for gastric cancer is the range of lymphnode dissection, however, the scholars have discordant opinions, including the lymphnode dissection of the No.12group and, the main gastric cancers in our country aregastric body and non-proximal gastric antrum cancer. Therefore, in this article, I willanalyze the circumstance of the No.12group lymph node dissection when having theconservative treatment on gastric body and gastric antrum, then; explore the necessity,feasibility and significance of the No.12group of lymph node dissection.Method: Retrospectively collected59cases which the patients with the body orthe distal stomach of the proximal stomach cancer, and they are all line distal stomachradical resection, all the cases do D2or lymph node dissection and are more than D2including lymph node dissection of the patients of No.12in the Department of GeneralSurgery of The Second Affiliated Hospital of Dalian Medical University, from January2002to December2011. The No.12lymph nodes and the commonly with theremaining lymph node and tumor primary lesions, fixed with10%formalin,paraffin-embedded, sliced, stained by HE, to do conventional histological examination.Last recorded patient sex, tumor size, tumor location, depth of invasion, Borrmann typeand degree of differentiation, and record the number of metastatic lymph nodes and ifthe No.12lymph code metastasized. The obtaining data will be analyzed with thestatistical software of the SPSS18.0, and take the χ2test, set inspection standards for α =005.Results: All the59patients with gastric cancer underwent radical distalgastrectomy. The No.12of lymph node metastasis in cancer patients of different gender:transfer rate of male patients was28.21%(11/39), and the female patient was15.00%(3/20), there was no significant difference (P>0.05). Patients of different tumor size:transfer rate was10.34%(3/29) when the tumor diameter <4cm, while the transfer ratewas36.67%(11/30) when the tumor diameter≥4cm, the difference was statisticallysignificant (P <0.05). Patients with tumors of different parts: A patient with gastric bodycancer, transfer rate was35.71%(5/14), gastric antrum in patients with transfer rate was10.00%(9/45), and the difference was not statistically significant (P>0.05). Tumors ofdifferent patients with Borrmann type, lymph node metastasis: Patients with Borrmann Iand II (localized) transfer rate was4.55%(1/22), Borrmann III, IV type (infiltrative type)in patients with metastatic rate was35.14%(13/37), the difference was statisticallysignificant (P <0.05).Tumor patients with different infiltrative depth: not invading theserosa was0%(0/14) while invading was31.11%(14/45), the difference was statisticallysignificant (P <0.05). Patients with different tumor differentiation: the highdifferentiated group was8.33%(2/24),34.21%of the poorly differentiated group(12/35), the difference was statistically significant (P <0.05).Conclusion:1. The No.12lymph node metastasis has no obvious correlation with sex and thelocation of the cancer.2. The No.12lymph node metastasis has significant correlation with cancer size≥4cm, frequency focal depth of infiltration serous layer, Borrmann points for Ⅲ type,Ⅳ type and histological for low differentiation.3. The serosa without invasion could be considered without the No.12lymph node dissection. |
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