- 期刊
胃旁淋巴腺大小與胃癌轉移之關係
The Correlation between the Size of Regional Lymph Nodes and Metastases in Gastric Cancer
摘要
胃旁淋巴腺腫大代表癌轉移嗎？淋巴腺出現癌轉移時可能有多大？含癌轉移的淋巴腺中，距離癌灶近的較大，還是較遠的較大？這些都是外科醫師們最關心的問題。為求瞭解，特收集最近3年，在高雄醫學院外科手衍切除胃癌病例計72 例，回溯性地計其病理切片上所有廓清淋巴腺之面積，歸納出下列結果： (1)胃癌切除標本上，廓清的淋巴腺數目，有淋巴腺轉務例與冉淋巴腺轉務例之問，冉統計學上有意義之差異。 (2)含癌轉移的淋巴腺較不含癌轉移的淋巴腺大，統計學上呈有意義之差異。 (3)含癌轉移的淋巴腺，其大小與距雞癌灶之遠近無關。 (4)淋巴腺轉移率（%）=0.3 × （新鮮淋巴腺最大切面面積）+26。
關鍵字
無資料並列摘要
Is any enlarged regional lymph node metas-tatic in gastric cancer? What size of a regional lymph node should be suspected to be metas-tatic? Is the size of a metastatic Iymph node influenced by the distance away from the cancerous lesion? Every surgeon 15 seriously concemed about such questions. In this study we have collected 72 cases of gastric cancer requiring radical operation in the past 3 years. Each regional lymph node, totaling 1945, was measured for the largest cut surface area from the pathology slide. The cut surface area of a fresh lymph node was estimated to shrink to 60.4% after formalin fixation and alcohol dehydration. Median test was employed for statistical analysis. The following results were obtained : (l) On the average, each pathology speci-men contained 27.0 lymph nodes. The average number of lymph nodes removed in the metas-tatic cases was 28.3 and in the non-metastatic cases was 24.0. The difference was not statisti-cally significant. (2) A metastatic lymph node was round to be signiflcantly larger than a non-metastatic one(p＜0.001). (3) The metastatic regional lymph nodes were classified into 3 groups according to the general rules for the gastric cancer sudy in surgery and pathology proposed by the Japanese Research Society for gastric cancer. Among these 3 groups, there was no statistically signify-cant difference in the size of Iyrnph nodes. (4) There was a signiflcantly positive corre-lation between the metastatic rate and the largest cut surface area of a lymph node: The metastatic rate of a lymph node (%)=0.49*(the largest cut surface area on slide)+ 25.7, r = 0.73 From the above , we were able to corne to the following conclusions : (l) The number of regional lymph nodes removed in metastatic gastric cancer was not sig-niflcantly more than that in non-metastatic cases. (2) A metastatic lymph node was signifi-cantly larger than a non-metastatic one. (3) The size of metastatic regional lymph nodes had no definite correlation with the distance away from the cancerous lesion. (4) The metastatic rate of a lymph node (%) = 0.3x ( the largest cut surface area in fresh status ) + 26