目的 探究脾脏第10组淋巴结转移情况对行脾脏保留胃癌根治术治疗胃中上部癌患者手术预后的影响。方法 选取 2010年1月-2014年1月于许昌市中心医院行脾脏保留胃癌根治术治疗的298例胃中上部癌患者为研究对象，术后随访 3年，根据患者住院复查、门诊复查和电话随访等方式记录患者3年生存率情况。结果 单因素分析结果显示，术前 CEA、术前CA72-4、肿瘤直径、Borrmann分型、肿瘤浸润深度、淋巴结转移分期、第10组淋巴结转移和胃周癌结节 形成可影响胃中上部癌患者脾脏保留胃癌根治术后3年生存率(P<0.05)；多因素分析结果显示，肿瘤浸润深度T4、 肿瘤TNM分期ⅢC期、第10组淋巴结转移、胃周癌结节形成均为影响胃中上部癌患者脾脏保留胃癌根治术预后的独立 危险因素(P<0.05)。结论 肿瘤浸润深度T4、肿瘤TNM分期ⅢC期、第10组淋巴结转移、胃周癌结节形成是影响胃中 上部癌患者脾脏保留胃癌根治术预后的独立危险因素。

Objective To investigate the effect of metastasis of group 10 splenic lymph node on the prognosis of patients with upper and middle gastric cancer undergoing spleen preserving radical gastrectomy. Methods From Jan. 2010 to Jan. 2014, a total of 298 patients with upper and middle gastric cancer undergoing spleen preserving radical gastrectomy in our hospital were taken as the research objects. All the patients were followed up for 3 years, and the 3-year survival rates were recorded according to their hospital review, outpatient review and telephone follow-up. Results Univariate analysis showed that preoperative CEA, preoperative CA72-4, tumor size, Borrmann type, depth of tumor invasion, lymph node metastasis staging, metastasis of group 10 lymph node and formation of gastric cancer nodules can affect the 3-year survival rates of patients with upper and middle gastric cancer undergoing spleen preserving radical gastrectomy(P<0.05), multivariate analysis showed that the T4 depth of tumor invasion, the ⅢC stage in TNM classification of tumor, metastasis of group 10 lymph node and formation of gastric cancer nodules were independent risk factors affecting the prognosis of patients with upper and middle gastric cancer undergoing spleen preserving radical gastrectomy(P<0.05). Conclusion T4 depth of tumor invasion, the ⅢC stage in TNM classification of tumor, metastasis of group 10 lymph node and formation of gastric cancer nodules are independent risk factors affecting the prognosis of patients with upper and middle gastric cancer undergoing spleen preserving radical gastrectomy.