关键词: font-size:10.5pt, 胃癌')">">胃癌, 淋巴结送检数目, 腹腔镜手术, 影响因素

Abstract:  

Objective To analyze the factors influencing the optimal number of lymph node detection in laparoscopic radical gastrectomy for advanced gastric cancer. Methods The data of 536 patients with advanced gastric cancer who underwent laparoscopic radical gastrectomy from January 2018 to July 2020 were reviewed, and the clinicopathological data was analyzed. The number of lymph nodes was submitted for detection after surgery, and the factors influencing the number of lymph nodes for detection were analyzed. Results Among the 536 patients, 147 had no lymph node metastasis and 389 had lymph node metastasis. In patients without lymph node metastasis, there was a statistically significant difference in tumor diameter between the group with lymph node number ≥16 and the group with lymph node number <16 (P=0.027). Receiver operator characteristic (ROC) curve analysis showed that the area under curve of the tumor diameter predicting the number of lymph nodes ≥16 for detection was 0.719 (95% CI:0.627-0.810, P<0.001), and the optimal cut'off value was 2.8 cm. In patients with lymph node metastasis, there were statistically significant differences in age and lymph node metastasis between the group with lymph node number ≥30 and the group with lymph node number<30 (P<0.05). The results of multivariate Logistic regression analysis showed that age and lymph node metastasis (N3a and N3b)were independent factors affecting lymph nodes number <30 for detection(P< 0.05). ROC curve analysis showed that the area under curve of age and lymph node metastasis predicting number of lymph node metastasis≥30 for detection were 0.575 (95% CI:0.519-0.632, P=0.008) and 0.615 (95% CI:0.559-0.672,P<0.001), respectively. The optimal cut'off values were 54 years old and 6. Conclusion Patients with tumor diameter ≤2.8 cm without lymph node metastasis were more likely to have <16 lymph nodes for detection. Patients aged >54 years and with no more than 6 metastatic lymph nodes were more likely to have <30 lymph nodes for detection. In clinical work, various influencing factors should be comprehensively considered to ensure sufficient lymph node detection, so as to formulate individualized treatment plan and improve the quality of treatment.

Key words: Gastric tumor, Number of lymph nodes detection')">">, Laparoscopic surgery')">">, Influencing factor