目的 探讨胃癌患者肠系膜上静脉旁淋巴结(No.14v)转移的相关影响因素.方法 回顾性分析南京大学医学院附属鼓楼医院普通外科2010年9月至2011年10月在胃癌根治术中进行No.14v淋巴结清扫的70例进展期胃癌患者的临床资料,分析影响No.14v淋巴结转移的相关临床病理因素.结果 70例胃癌患者中,No.14v淋巴结转移阳性者8例(114％).单因素分析显示,No.14v淋巴结转移与胃癌肿瘤部位(P=0.019)、肿瘤大小(P=0.004)、浸润深度(P=0.001)、TNM分期(P=0.006)及其他各组淋巴结转移(分别为P＜0.05和P＜0.01)有关.多因素分析证实,No.6淋巴结转移为No.14v转移的独立危险因素(P=0.000).No.6淋巴结转移预测No.14v转移的准确度为94.3％(66/70),假阴性率为1.7％(1/60).结论 No.6淋巴结转移与否能够较准确地预测No.14v转移情况.%Objective To investigate the risk factors associated with metastasis of lymph node along superior mesenteric vein (No.14v) in gastric cancer.Methods Clinicopathological data of 70 gastric cancer patients undergoing gastrectomy with No.14v dissection between September 2010 and October 2011 in the Gulou Hospital,Nanjing University School of Medicine were analyzed retrospectively.Associated factors of No.14v lymph nodes metastasis were investigated.Results Of 70 cases,positive No.14v lymph node metastasis was found in 8 cases (11.4％).Univariate analysis showed that the No.14v metastasis was associated with tumor location (P=0.019),tumor size (P=0.004),depth of invasion (P=0.001),TNM staging (P=0.006),and other lymph node group metastasis (all P＜0.05),and was not associated with age,gender,Borrmann classification,Lauren classification or histological type(all P＞0.05).Multivariate analysis revealed that lntra-pyloric lymph nodes(No.6) metastasis was an independent risk factor of No.14v metastasis (P＜0.05).The predictive accuracy was 94.3％ (66/70) and false-negative rate was 1.7％ (1/60) for No.6 lymph node metastasis.Conclusion No.6 lymph node metastasis status can predict the metastasis of No.14v more accurately.
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