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目的探讨进展期胃癌第10组淋巴结转移的预测方法。方法回顾性分析北京肿瘤医院2006年1月至2009年12月行根治术并第10组淋巴结清除的142例胃癌患者的临床病理资料和Ki-67、基质金属蛋白酶7(MMP7)、p53免疫组织化学结果,分析第10组淋巴结转移的危险因素。结果全组患者淋巴结转移率为66.2%(94/142),第10组淋巴结转移率为16.2%(23/142)。单因素分析结果显示,第10组淋巴结转移与肿瘤部位、肿瘤大小、Bormann分型、浸润深度、第4s组淋巴结转移有关,而与分子标志物Ki-67、MMP7、p53的表达无关。多因素分析显示,第4s组淋巴结转移是第10组淋巴结转移的独立危险因素。第4s组淋巴结阴性者,第10组淋巴结转移率为7.8%;第4s组阳性者,第10组淋巴结转移率为26.6%。结论第4s组淋巴结转移是进展期胃癌第10组淋巴结转移的危险因素,但是尚不能将其阴性预测几率降至5%以下。我们不能有效预测第10组淋巴结阴性胃癌病例。
Objective To investigate the predictive method of lymph node metastasis in advanced gastric cancer group 10. Methods The clinical and pathological data of 142 patients with gastric cancer who underwent radical mastectomy and group 10 lymph node dissection from January 2006 to December 2009 in Beijing Cancer Hospital were retrospectively analyzed. The expressions of Ki-67, MMP-7, Chemical results, analysis of the 10th group of risk factors for lymph node metastasis. Results The rate of lymph node metastasis in all patients was 66.2% (94/142). The rate of lymph node metastasis in group 10 was 16.2% (23/142). Univariate analysis showed that lymph node metastasis in group 10 was related to tumor location, tumor size, Bormann classification, depth of invasion, lymph node metastasis in group 4s, but not to molecular markers Ki-67, MMP7 and p53. Multivariate analysis showed that lymph node metastasis in group 4s was an independent risk factor for lymph node metastasis in group 10. In group 4s with lymph node negative, group 10 lymph node metastasis was 7.8%; group 4s positive, group 10 lymph node metastasis rate was 26.6%. Conclusion Lymph node metastasis in group 4s is a risk factor for lymph node metastasis in advanced gastric cancer group 10, but its negative predictive value can not be reduced below 5% yet. We can not effectively predict group 10 lymph node-negative gastric cancer cases.