The Incidence And Analysis Of Risk Factors Of No.8p Lymph Nodes Metastases In Resectable Advanced Gastric Cancer

Objective:To investigate the incidence of No.8p lymph nodes metastases in patients with resectable advanced gastric cancer who have negative metastases of posterior lymph nodes of common hepatic artery in clinical evaluation,and explore the possible relation between the clinical and pathological features and the No.8p lymph nodes metastases.In which the study could provide some evidence in reasonable local lymph nodes dissection for high-risk group of No.8p lymph nodes metastases.Methods:selecting 97 cases of resectable advanced gastric cancer as the object of study who had performed the operation in China Japan Union Hospital of Jilin University from October 2016 to January 2018,and no No.8p lymph nodes metastases occurred in clinical evaluation(preoperative imaging assessment and intraoperative exploration).All patients performed the D2 plus No.8p lymph nodes lymphadenectomy.Investigating the incidence of No.8p lymph nodes metastases in these patients,and exploring the possible relevance between the clinicopathological factors and the posterior lymph nodes of common hepatic artery.Results:1.On the whole,13 of 97 patients(13.4%)had positive posterior lymph nodes of common hepatic artery,and 13 of 81 patients who had positive lymph nodes(16.0%).No.8p lymph nodes metastases are presented in 8 of 19(42.1%)patients who are in T4 stage,No.8p lymph nodes metastases are presented in 11 of 29(37.9%)patients who are in N3 stage.2.The number of dissected lymph nodes were 30.87±9.30 per patient,the number of positive lymph nodes were 4(7);The number of dissected lymph nodes were 29.80±8.77 per patient with total gastrectomy,the number of positive lymph nodes were 8(12);The number of dissected lymph nodes were 31.25±9.51 per patient with distal gastrectomy,the number of positive lymph nodes were 3.5(5);3.The number of dissected No.8p lymph nodes were 2.11±1.14 per patient,the number of positive lymph nodes were 1(0);The number of dissected No.8p lymph nodes were 2.04±0.93 per patient with total gastrectomy,the number of positive lymph nodes were 1(0);The number of dissected No.8p lymph nodes were 2.14±1.20 per patient with distal gastrectomy,the number of positive lymph nodes were 1(0);4.Univariate analysis results showed that there were significant differences in tumor size(P=0.018<0.05),preoperative imaging evaluation results(P=0.01<0.05),T stage of tumor(P=0.001<0.05)and N stage of tumor(P<0.001)as for whether No.8p lymph nodes metastases occurred,but no statistical differences were observed in different age,gender,location of tumor,expression of tumor makers,differentiation grade,histological type and Lauren type.5.multivariate analysis results indicated that T stage(P=0.006,95%CI:0.017-0.500)and N stage(P=0.018,95%CI:0.015-0.675)were the independent risk factors for No.8p lymph nodes metastases,but tumor size and preoperative imaging evaluation results were not independent risk factors of No.8p lymph nodes metastases.6.A significant difference in MLR distribution between the cases with positive No.8p lymph nodes metastases and the cases with negative metastases could be detected,most of patients who had positive No.8p lymph nodes metastases were usually distributed in high-grade of MLR,namely,MLR3-MLR5.Conclusions:1.Patients from resectable advanced gastric cancer have a degree of No.8p lymph nodes metastases.2.T stage and N stage are independent risk factors for No.8p lymph nodes metastases,No.8p lymph nodes lymphadenectomy for patients with advanced T stage or N stage in resectable advanced gastric cancer has positive clinical significance which can improve the effect of radical excision.3.Patients with positive No.8p lymph nodes metastases in advanced gastric cancer have high-grade distribution of MLR.