The Clinical Application Value Of Sorting Lymph Node In Vitro After Radical Gastrectomy

Objective:The clinical application value of sorting lymph node in vitro after radical gastrectomy was discussed by comparing with the traditional processing methods for postoperative specimens,so as to provide reference ideas for the standardization of the processing methods of surgical pathological specimens.Methods:This study retrospectively analyzed the clinical and pathological data of105 gastric cancer patients who undergone standard D2 radical gastrectomy in the Department of Gastrointestinal Surgery,Affiliated Hospital of Qinghai University from September 2016 to October 2018,and divided into two group:the lymph node sorted group(experimental group,50cases)and the lymph node unsorted group(control group,55cases).The differences of the two groups were compared in the evaluation of surgical quality,prognostic evaluation and guidance for the choice of postoperative adjuvant therapy.Results:There were no statistically significant differences between the two groups in baseline data such as age,gender,body mass index,tumor location,tumor size,histological type,T stage,Borrmann classification,Lauren classification,surgical method,surgical resection range and preoperative neoadjuvant chemotherapy(p>0.05).The experimental group was significantly better than the control group in the evaluation of surgical quality and the choice of postoperative adjuvant therapy.In terms of prognostic evaluation,the total number of lymph node examined(TNLE),the number of negative lymph nodes and the number of positive lymph nodes in the experimental group were significantly more than those in the control group(t=-5.107,p=0.000;t=2.929,p=0.005;t=-4.237,p=0.000).Metastatic lymph node ratio and lymph node rate(LNR)in the experimental group were significantly higher than those in the control group(?~2=12.340,p=0.000);?~2=27.882,p=0.000).In the comparison of N staging,rN staging and TNM staging between the two groups,it was found that all the staging systems in the experimental group presented a phenomenon of late deviation,and the difference was statistically significant.Conclusion:Lymph node sorted in vitro by surgeons after radical gastrectomy can significantly increase the number of lymph nodes examined,thereby reduce the occurrence of staging deviation and improve the accuracy of prognosis evaluation.In addition,the detailed description of lymph node metastasis information in each group also highlights obvious advantages in the evaluation of surgical quality and the selection of postoperative adjuvant therapy.So it is worthy of clinical application.