摘要目的 探讨胃癌淋巴结转移过程中对胃周围血管鞘的影响,为胃癌的外科治疗提供理论依据.方法 收集2004年1月至2006年1月收治的47例胃癌患者的手术标本,其中包括血管鞘的胃左和(或)胃右动脉标本90份,采用冷冻切片,并经HE染色及免疫组积化学染色.结果 Ⅰ期胃癌未发现癌细胞转移至血管鞘内.共有10例25份标本血管鞘内和(或)鞘上发现转移的癌细胞,其中Ⅱ期胃癌有1例2份标本,Ⅲ期胃癌有3例8份标本和Ⅳ期胃癌有6例15份标本.各期胃癌的角质蛋白(CK)阳性率比较差异有统计学意义(P＜0.01).结论 对Ⅱ期以上的进展期胃癌根治术需要采用鞘内分离以彻底清扫动脉周围淋巴结.

abstractsObjective To explore the effect of lymph node metastases in gastric cancer on vagniae vasorum of gastric vessels,in order to provide evidence for the surgical treatment of gastric cancer.Methods The study included 90 specimens of left and right gastric arteries from 47 patients who underwent radical gastrectomy for carcinoma from January 2004 to 2006.All specimens were dealt with frozen section method,then they were stained with HE and immunohistochemical method respectively.Results Metastatic cancer cells were not found inside vagina vasorum in stage Ⅰ specimens.Cytokeratiu positive of tumor cens in or on vagina vasorum was showed on 25 slices from 10 tumors.Among them,2 slices from 1 tumor belonged to stage Ⅱ.8 slices from 3 tumors belonged to stage Ⅲ and 15 slices from 6 tumors belonged to stage Ⅳ.There was significant differences among cytokeratin positive rate in different stages of gastric cancer(P＜0.01).Conclusion Vaginae vasorum dissection is recommended when clearing lymph node around arteries in radical gastrectomy for carcinomas in stage Ⅱ above.