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find Keyword "淋巴结检出数目" 2 results
  • Analysis of factors influencing total number of harvested lymph nodes in laparoscopic radical gastrectomy for advanced gastric cancer

    ObjectiveTo analyze the factors influencing the total number of harvested lymph nodes in laparoscopic radical gastrectomy for advanced gastric cancer.MethodsThe clinicopathologic data of patients who underwent laparoscopic D2 radical resection of gastric cancer in this hospital for advanced gastric cancer from January 2018 to July 2020 were retrospectively analyzed. The statistical analysis was conducted to analyze the influence factors (age, gender, tumor size, tumor site, body mass index, infiltration depth, lymph node metastasis, HER-2 gene amplification status, presence or absence of vascular tumor thrombus, presence or absence of nerve infiltration, differentiation type, pTNM, Borrmann type, and type of gastrectomy) on the number of harvested lymph nodes.ResultsA total of 536 patients met the inclusion and exclusion criteria were included. The results of univariate analysis showed that the total number of harvested lymph nodes during laparoscopic radical gastrectomy for advanced gastric cancer was correlated with age, tumor size, tumor infiltration depth, lymph node metastasis, pTNM stage, Borrmann type, and type of gastrectomy. That was, the younger the patient was (≤ 54 years old), the larger the tumor was (long diameter >3.5 cm), the later the Borrmann classification was (type Ⅲ, Ⅳ), the deeper the tumor invasion was, the more the number of lymph node metastasis was, the later the pTNM stage was, and the more the number of lymph nodes was detected in patients undergoing total gastrectomy (all P<0.05). The multiple linear regression analysis showed that the age, lymph node metastasis, and PTNM stage had significant effects on the number of harvested lymph nodes. The multiple linear regression model was statistically significant (F=6.754, P<0.001). 11.2% of the variation in the number of harvested lymph nodes could be explained by the age, lymph node metastasis, and pTNM stage (adjusted R2=11.2%). ConclusionsNumber of harvested lymph nodes in laparoscopic radical gastrectomy for advanced gastric cancer is greatly affected by the age of patients, lymph node metastasis, and pTNM stage. So patients should be evaluated objectively and individually according to their age so as to harvest sufficient number of lymph nodes, which is conducive to accurately judge pTNM stage, formulate accurate adjuvant treatment scheme, and improve prognosis of patients.

    Release date:2021-06-24 04:18 Export PDF Favorites Scan
  • 局部进展期中低位直肠癌新辅助治疗对淋巴结检出数目的影响及预后分析

    目的分析接受新辅助治疗的局部进展期中低位直肠癌患者在根治性切除术中可能影响淋巴结检出数目的因素,并分析淋巴结检出数目对预后的影响。方法回顾性分析2016年3月至2021年12月期间西安交通大学第一附属医院收治且接受新辅助治疗联合根治性手术的局部进展期中低位直肠癌患者的临床病理资料,采用线性回归模型筛选影响淋巴结检出数目的因素,Kaplan-Meier法绘制生存曲线。结果共收集到81例局部进展期中低位直肠癌根治性切除术患者,淋巴结检出数目(12.11±5.54)枚/例;检出淋巴结平均数目 <12枚者42例、≥12枚者39例。多因素线性回归模型分析结果显示,男性患者和联合新辅助放疗可降低检出淋巴结数目的概率(分别为:t=–3.17,P=0.002;t=–2.44,P=0.017)。以检出淋巴结平均数目12枚为截点分析 <12枚和 ≥12枚患者的Kaplan-Meier法绘制的生存曲线,经log-rank检验发现,检出淋巴结平均数目 <12枚和 ≥12枚患者的总生存和无病生存曲线比较差异均无统计学意义(分别为:χ2=0.107,P=0.743;χ2=0.027,P=0.870)。对64例临床区域淋巴结阳性患者将淋巴结检出数目平均6~13枚分别以 <6枚/≥6枚、……和 <13枚/≥13枚作为分组截点进行分层分析的结果显示,以平均7枚和8枚淋巴结检出数目作为分组截点的2组患者的累积总生存情况比较差异有统计学意义(χ2=3.977,P=0.046;χ2=3.977,P=0.046),即检出淋巴结平均数目至少7枚或8枚者的总生存情况更好。结论本研究的数据分析结果提示,男性患者和联合了新辅助放疗的患者对术后获检淋巴结数目会有一定的影响;从总体患者的生存分析看,未发现检出淋巴结数目与总生存和复发有关,但在临床区域淋巴结阳性的患者中发现,至少检出7枚或8枚淋巴结可以改善患者的预后。

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