| Objective:To discuss the rule of lymph node metastasis in gastric cancer and provide the basis for the standard surgery.Methods:Collected clinical data of 12,633 standard gastric cancer cases from April 1958 to August 2015,and observed the circumstances of the lymph node metastasis.Results:1.The total lymph node metastasis rate was 58.14%,the lymph node metastasis rate of early gastric cancer was 12.72%,and the lymph node metastasis rate of advanced gastric cancer was 63.41%.2.Lymph node metastasis rate in each group2.1 The highest rate of each group lymph node metastasis in the total gastric cancer and advanced gastric cancer is No.7,then successively is No.3,1,6,4,2,8,5,9,11,12,16,10,14,13,15.2.2 The highest rate of each group lymph node metastasis in early gastric cancer is No.3,then successively is No.6,7,4,1,8,5,2,9,11,12,10,14,16.3.Lymph node metastasis of various clinical indicators in different stages of gastric cancer3.1 In the total gastric cancer,there are significant differences with the lymph node metastasis rate in the gender,location of tumor,tumor size,histological type,depth of invasion,TNM staging.3.2 In the early gastric cancer,there are significant differences with the lymph node metastasis rate in the gender,location of tumor,tumor size,histological type,depth of invasion.3.3 In the advanced gastric cancer,there are significant differences with the lymph node metastasis rate in the gender,location of tumor,tumorsize,Borrmann type,histological type,depth of invasion,TNM staging.4.Each group lymph node metastasis rate in different location of tumor4.1 Upper stomach cancer group:The highest rate of each group lymph node metastasis in the total gastric cancer and advanced gastric cancer is No.7,then successively is No.1,3,2,4,8,16,9,11,5,6,10,12,14,15,13;in the early gastric cancer is No.7,then successively is No.3,1,2,6,4,8,11.4.2 Middle stomach cancer group:The highest rate of each group lymph node metastasis in the total gastric cancer is No.3,then successively is No.7,1,4,6,2,5,8,9,11,12,10,16,13,14,15;in the early gastric cancer is No.3,then successively is No.7,1,4,5,2,6,8,11,9,10,14;in the advanced gastric cancer is No.3,then successively is No.7,1,4,6,2,8,5,9,11,12,10,16,13,14,15.4.3 Lower stomach cancer group:The highest rate of each group lymph node metastasis in the total gastric cancer is No.6,then successively is No.3,4,7,5,8,1,9,12,11,2,14,13,15,16,10;in the early gastric cancer is No.6,then successively is No.3,4,7,8,5,9,1,12,2,16;in the advanced gastric cancer is No.6,then successively is No.3,4,7,5,8,1,12,9,11,2,14,13,15,16,10.4.4 multi-site stomach cancer group:The highest rate of each group lymph node metastasis in the total gastric cancer is No.3,then successively is No.7,1,4,6,2,8,5,11,9,10,12,14,15,16,13;there are no lymph node metastasis in the early gastric cancer.5.Multivariate analysis result shows:female,middle and lower stomach cancer,tumor diameter?2cm,poorly differentiated type and tumor infiltration T1 b are independent risk factors that affecting lymph node metastasis in early gastric cancer.And lower and multi-site stomach cancer,poorly differentiated type,tumor infiltration T3-4 and TNM II-IV stage are independent risk factors that affecting lymph node metastasis in advanced gastric cancer.Conclusion:1.The lymph node metastasis rate was 58.14% in gastric cancer,12.72%in early stage and 63.41% in advanced stage.2.Each group lymph node may occur metastasis in gastric cancer,and thelymph node in the lesser curvature of stomach are more likely to occur metastasis and there is a possiblity of skipping metastases.So,surgical treatment of gastric cancer should focus on the removing the lymph nodes of the lesser curvature of stomach and D2 radical surgery should be implementated strictly.3.Incidence of lymph node metastasis in early gastric cancer is related to gender,location of tumor,tumor size,histological type,depth of invasion,and has no relation with age,general classification.Among them,female,middle and lower stomach cancer,tumor diameter ? 2cm,poorly differentiated type and tumor infiltration T1 b are independent risk factors.4.Incidence of lymph node metastasis in advanced gastric cancer is related to Sex,location of tumor,tumor size,Borrmann type,histological type,epth of invasion,and has no relation with age.Among them,lower and multi-site stomach cancer,poorly differentiated type,tumor infiltration T3-4and TNM II-IV stage are independent risk factors. |
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