【摘要】 目的探讨原发性肝癌患者肝门淋巴结转移的相关因素、转移规律以及肝门淋巴结清扫对其预后的影响。方法对113例原发性肝癌患者在肝脏切除前常规进行肝门区域淋巴结清扫;对淋巴结转移的发生率、部位、术前术后诊断符合率以及对预后的影响进行分析。结果原发性肝癌113例中18例(15.93%)患者有淋巴结转移,其中肝细胞肝癌10例,胆管细胞癌7例,混合型肝癌1例。术中门静脉、胆总管及肝动脉周围的淋巴结均被清扫,清扫的淋巴结平均数为(3.8±1.6)个。有肝门淋巴结转移者中位生存时间为13个月,而无肝门淋巴结转移者中位生存时间为25个月,两者2年生存率分别为17.12%和49.83%,差异有统计学意义。结论淋巴结状态是肿瘤患者1个重要的预后因素,显著影响患者生存率。肝门淋巴结清扫是安全的,对没有慢性肝病的胆管细胞性肝癌患者应常规应用。更多还原

【Abstract】 Objective To investigate the factors that related to the metastasis of portal lymph node in the patients with primary liver cancer,the patterns of lymphatic invasion and the influence on prognostic of the patients received lymphadenectomy.Methods 113 patients with primary liver cancer underwent the resection of portal lymph node before the conventional hepatectomy.Incidence rate,location,coincidence of pre-and postoperative diagnosis and the influence on prognosis of node metastasis were analyzed.Results The metastasis of portal lymph node existed in 18 cases(15.93%)among 113 cases of primary liver cancer,including 10 cases of hepatocelluar carcinoma,7 cases of cholangiocellular carcinoma,and 1 cases of mixed hepatoma.Lymph nodes near periportal,bile duct,and common hepatic artery were all removed.The median number of resected nodes was 3.8 ± 1.6.The median survival time of the patients with the metastasis of portal lymph node was 13 monthes;while the median survival time of the patients without the metastasis was 25 monthes.Their 2-year survival rate was 17.12% and 49.83% for patients with and without portal node metastasis,and there is significant difference between them.Conclusion Lymph node status is one of the most important prognostic factors for the patients of carcinoma.The resection of portal lymph node is safe,and should be routinely applied in patientswith cholangiocellular carcinoma,especially in the patients without chronic disease.更多还原