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期刊信息/Journal information
中华胃肠外科杂志
中华胃肠外科杂志

汪建平

月刊

1671-0274

china_gisj@vip.163.com

020-38254955

510655

广东省广州市天河区员村二横路26号

中华胃肠外科杂志/Journal Chinese Journal of Gastrointestinal SurgeryCSCD北大核心CSTPCD
查看更多>>1998年5月创刊，中国科协主管，中华医学会、中山大学主办。本刊是我国惟一的胃肠外科专业学术期刊，办刊宗旨为全面系统地反映国内外胃肠外科领域的学术动态，促进胃肠外科的学科发展和学术交流。本刊的主要读者对象为从事胃肠外科、普通外科及相关专业的临床、科研、教学的高、中级医师。设置的栏目有述评、专家笔谈、论著、短篇论著、临床经验、病例报告、术式交流、MDT病例讨论、诊治指南、讲座、综述及医学信息等。
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    食管胃结合部腺癌外科治疗中国专家共识（2024年版）

    胡建昆陈龙奇季加孚李印...
    109-126页
    查看更多>>摘要：《食管胃结合部腺癌外科治疗中国专家共识（2018版）》自颁布以来，很大程度上促进了我国食管胃结合部腺癌（AEG）的规范化、同质化诊疗，提升了我国AEG的外科治疗水平。经过5年的临床实践，该共识普适性和可行性已得到广泛证实。鉴于AEG发病率持续上升的趋势及其解剖部位、临床病理特征和分子生物学特征的特殊性，AEG成为近5年来外科临床研究的热点之一，并不断有新的临床研究证据发表。但是，对于AEG的定义、分型、分期、手术路径、切除范围、淋巴结清扫规范和消化道重建等外科问题，仍旧存在争议。鉴于此，有必要对2018版的共识进行更新。《食管胃结合部腺癌外科治疗中国专家共识（2024版）》在前一版的基础上，整合并分析5年来新的最佳临床证据，参考最新国际指南与共识，结合我国外科专家组意见，针对AEG外科治疗关键环节，包括AEG的定义和分型、手术径路、手术方式、淋巴结清扫范围、消化道重建方式及外科围手术期治疗等存在争议的问题，提出相关推荐建议，以期更好地规范AEG的外科治疗方式。在本共识中未解决的相关问题，尚需积极开展高质量的临床研究，以逐步探索和解决。 The publication of Chinese expert consensus on the surgical treatment for adenocarcinoma of esophagogastric junction (2018 edition) has widely accelerated the standardization and homogenization on the surgical treatment of adenocarcinoma of esophagogastric junction (AEG). In China, the surgical outcomes of AEG, the universality and practicability of this consensus has also been affirmed after the clinical practice during the past 5 years. Due to the persistent increasing incidence of AEG, the specificity on anatomic site, clinicopathological characteristics, molecular biological characteristics, AEG had been always the hotspot of many clinical trials and more clinical evidences had been published. However, its definition, classification, staging, surgical approach, resection pattern, extent of lymphadenectomy, and the digestive tract reconstruction etc. remain controversial. In light of the above, it is necessary to update the 2018 edition of consensus. The Chinese expert consensus on the surgical treatment for adenocarcinoma of esophagogastric junction (2024 edition) is generated based on the currently available and best clinical evidence, the latest global guidelines or consensuses, and the opinions from the Chinese expert panel. The present consensus focuses on the key points of surgical treatment and issues in dispute, and provides scientific recommendations. The goal of this expert consensus was to improve the homogeneity in understanding and practice between Chinese thoracic and gastrointestinal surgeons, and to further standardize surgical treatment of AEG. Those pending issues in this consensus need high-quality clinical research to further investigate.

    食管胃结合部腺癌食管肿瘤胃肿瘤外科专家共识

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    食管胃结合部腺癌外科治疗中国专家共识（2024年版）解读

    刘凯朱云峰杨玉赏陈龙奇...
    127-131页
    查看更多>>摘要：食管胃结合部腺癌（AEG）由于解剖位置的特殊性，其定义、分期及治疗策略存在诸多分歧与争议。2018年9月，我国发布了首部《食管胃结合部腺癌外科治疗中国专家共识（2018年版）》，积极推动了胸外科和普通外科医师AEG外科治疗策略的规范性和一致性。5年来，多项AEG临床研究结果的呈现，为AEG的外科治疗关键环节策略的选择提供了新的临床证据。因此，为进一步提升我国AEG外科临床实践的诊疗水平，在中国医师协会内镜医师分会腹腔镜外科专业组、国际食管疾病学会中国分会（CSDE）、中国食管胃结合部腺癌研究协作组、中国抗癌协会胃癌专委会和中华医学会肿瘤分会胃肠肿瘤学组的共同牵头和组织下，由25名胃肠外科专家和24名胸外科专家组成2024版食管胃结合部腺癌外科治疗中国专家共识编审专家组进行讨论修订，主要基于近5年来高级别临床研究证据完成共识的更新。最终形成了29项AEG外科治疗相关的推荐陈述，并提出了5项尚待探索的外科问题。本文主要针对修订后的共识推荐陈述进行解读。 Due to the unique nature of its anatomical location, the adenocarcinoma of esophagogastric junction (AEG) has been a subject of controversy and disagreement including its definition, staging, and treatment strategies. Chinse expert Consensus on Surgical Treatment of Adenocarcinoma of Esophagogastric Junction in China (2018 Edition) had been released in September 2018 and had played a pioneering role in unifying thoracic and general surgeons in China on surgical treatment strategies for AEG. Over the past five years, the emergence of several clinical research results on AEG has provided new clinical evidence for the selection of key surgical treatment strategies. Therefore, to further standardize the surgical treatment of AEG in China, Chinese Expert Consensus on Surgical Treatment of Adenocarcinoma of Esophagogastric Junction in China (2024 Edition) was released in 2024 by Chinese expert panel including 25 gastrointestinal surgeons and 24 thoracic surgeons. Based on the highest-level clinical research evidence in recent 5 years, this consensus ultimately formulates 29 recommendations on hotspots and key points on surgical treatment of AEG and summary 5 issues that are still awaiting further exploration. This review will provide a summary and detailed interpretation of the recommendations outlined in this consensus.

    食管胃结合部腺癌外科专家共识解读

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    胃癌数据库建立和管理的质量化控制

    吴晓龙李浙民陕飞李子禹...
    132-136页
    查看更多>>摘要：胃癌高质量数据库的建设有助于提高胃癌规范化诊治的水平和疗效。笔者中心建立了具有特色的单中心胃癌专病数据库，并通过胃肠肿瘤外科联盟推动多中心数据库模式探索。本文通过总结不同层面数据库的建设经验，深入阐述胃癌数据库建设及管理的质量化控制。基于信息化病历系统和多学科会诊模式，我们对数据库进行了模块化、多节点设计。结构化数据的自动调取与手工录入相结合，严格的多学科查房制度与数据录入相辅相成，不同节点实时监督强化了实时质控的效果，并通过实时审核与多级审核制度相结合，强调数据安全性以及管理计划信息化等措施，高质量地维护了数据库建立及管理流程。进一步通过中国胃肠肿瘤外科联盟平台的多中心数据库建设历程总结认为：应通过研究目标导向制定数据计划、充分考虑数据可及性和强调构建中心间数据共识等措施进行质量化控制。多中心数据库未来的建设应立足于稳定的公共数据共享平台，建立数据安全保障机制，并定期进行数据质量评估；同时，加强多中心合作与交流，进一步促进各中心医疗水平同质化。 The establishment of a high-quality gastric cancer database significantly improves the efficiency and standardization of diagnosis and treatment of this disease. Our center has developed a specialized, single-center gastric cancer database and initiated the China Gastrointestinal Cancer Surgery Union, catalyzing the exploration of multi-center databases. This article encapsulates multi-level experience and provides a detailed overview of the quality control methods we implement in both constructing and managing the gastric cancer database. Utilizing an electronic medical record system and a multi-disciplinary treatment (MDT) approach, we have designed the database in a modular and multi-nodal manner. A synthesis of automatic retrieval of structured data and manual entry, coupled with a rigorous MDT system and real-time supervision at various nodes, bolster our real-time quality control efforts. Ensuring data security and digitized management plans alongside real-time review protocol and a multi-level review system, we maintain the highest standards in the initiation and management of the database. Through the establishment of the China Gastrointestinal Cancer Surgery Union platform, we endorse the concept that multi-center database construction should be driven by research objectives, consider data accessibility, while placing an emphasis on building inter-center consensus on data quality control. Moving forward, it is crucial that the development of multi-center databases promotes uniformity in medical standards across centers, cultivates stable public data sharing platforms, ensures robust data security protocols, routinely conducts data quality assessments, and bolsters multi-center cooperation and exchanges to promote the homogeneity of medical standards.

    胃肿瘤数据库数据质量控制中国胃肠肿瘤外科联盟

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    早期胃癌诊断与治疗的质量化控制

    张子臻朱纯超曹晖卜建红...
    137-142页
    查看更多>>摘要：随着早期胃癌诊断技术和诊断率的不断提高，早期胃癌的诊疗质量逐渐受到关注，并成为胃癌整体诊疗水平提升的重要基础。早期胃癌的诊断和治疗方法多样，近几年，成熟技术手段的开展已经普及，前沿技术的发展迅速而有效，诊疗手段和治疗理念均在不断更新变化。为了保障早期胃癌的诊疗质量，制定早期胃癌的规范化诊疗质量控制制度，推进该制度在全国范围内同质化、标准化执行，建立相应的胃癌诊疗质量评价体系，对提升我国早期胃癌诊疗水平、降低我国胃癌病死率、改善我国胃癌患者预后以及提升我国早期胃癌的临床研究水平有重要意义。本文通过对早期胃癌的诊疗现状和技术发展归纳汇总并进行思考，从多学科诊疗、临床诊断技术、内镜和手术治疗、病理诊断和随访几方面提出了对早期胃癌诊疗过程的质量控制策略、内容和方案，以期对早期胃癌诊治流程的合理、规范和质量控制保障进行阐述。 With the developing technique of the diagnosis and treatment of early gastric cancer, the quality of early gastric cancer diagnosis and treatment is coming into focus, and is crucial to improve the overall management of gastric cancer. It is necessary to establish a quality control system to ensure the quality of diagnosis and treatment for EGC. Based on the summary of the diagnosis and treatment status and technological progress of early gastric cancer, this paper proposes the quality control strategy, content and plan for the diagnosis and treatment process of EGC from the aspects of multidisciplinary diagnosis and treatment, clinical diagnosis technology, endoscopic and surgical treatment, pathological diagnosis and follow-up, with a view to expound the rationality, standardization and quality guarantee of the diagnosis and treatment process for early gastric cancer.

    胃肿瘤,早期诊断治疗质量化控制

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    局部进展期胃癌腹腔镜手术胃切除范围的质量化控制

    郑华龙卫凌华陆俊黄昌明...
    143-147页
    查看更多>>摘要：经过近30年的探索与实践，以腹腔镜手术为代表的微创外科技术是目前胃癌外科治疗的重要手段。在中国，局部进展期胃癌腹腔镜根治术得到广泛开展，然而，针对进展期胃癌胃切除范围和方式尚存争议。笔者查阅国内外相关指南文献，结合团队实践经验，从手术适应证、肿瘤定位、胃上部和中部及下部肿瘤切除范围等方面阐述腹腔镜局部进展期胃癌胃切除范围的质量控制要点，旨在为更加规范地开展并推广腹腔镜胃癌根治手术提供参考。 After nearly 30 years of exploration and practice, minimally invasive surgical techniques represented by laparoscopic technology have become an important means for the surgical treatment of gastric cancer. In China, laparoscopic radical resection for locally advanced gastric cancer has been extensively carried out. However, there are still controversies regarding the gastric resection range and methods for advanced gastric cancer. By reviewing relevant domestic and foreign guideline documents and combining team practice experience, this article elaborates on the key points of quality control of laparoscopic gastric resection range for locally advanced gastric cancer from aspects such as tumor localization and gastric resection range for upper, middle and lower gastric tumors. It aims to provide reference for carrying out and promoting laparoscopic radical gastrectomy more safely.

    胃肿瘤,进展期腹腔镜胃癌根治术质量化控制微创外科

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    局部进展期胃癌淋巴结清扫的质量化控制

    柯彬梁寒卜建红
    148-152页
    查看更多>>摘要：多项临床研究已证实，D2淋巴结清扫是局部进展期胃癌的标准术式，标准化和规范化的淋巴结清扫是保证手术质量和提高疗效的关键。对局部进展期胃癌淋巴结清扫进行质量化控制时，建议依照第六版《日本胃癌治疗指南》的规定进行D2清扫；针对No.10、No.13、No.14v、No.16和纵隔淋巴结等D2清扫范围外的淋巴结，可依照指南和共识的建议，选择性地进行D2+淋巴结清扫，也可使部分患者获益。目前，局部进展期胃癌手术时联合大网膜切除仍是标准术式，是否保留大网膜仍需更多临床研究结果的验证。胃癌术后规范化的淋巴结送检为术后精准分期奠定基础，建议送检30枚以上的淋巴结以确保精准分期，避免分期偏倚。 Numerous studies have confirmed that D2 lymphadenectomy is the standard surgery for locally advanced gastric cancer. Standardized lymph node dissection plays a crucial role in ensuring surgical quality and efficacy. It is recommended to perform D2 lymph node dissection according to the 6th edition of the Japanese gastric cancer treatment guidelines. For lymph nodes beyond the scope of D2 lymph node dissection, such as No.10, 13, 14v, 16 and mediastinal lymph nodes, selective D2+ lymph node dissection can be performed, which may be advantageous for some patients. Currently, omentectomy is the standard surgical procedure for locally advanced gastric cancer. However, the clinical significance of gastrectomy with preservation of the greater omentum requires further validation through large-scale clinical trials. Standardized ex vivo lymph node dissection is important for accurate postoperative staging, and it is recommended to harvest more than 30 lymph nodes to avoid staging deviation.

    胃肿瘤,局部进展期根治术淋巴结清扫质量控制

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    近端胃切除消化道重建方式实施的质量化控制

    徐泽宽王林俊李沣员葛晗...
    153-157页
    查看更多>>摘要：随着食管胃结合部癌发病率的增高，近端胃切除术的应用率逐年上升。近端胃切除后消化道重建的方式种类繁多，部分重建方式问世时间尚短，存在术者临床经验较少、重建方式欠规范的情况。此状况势必会带来近端胃切除消化道重建后临床疗效参差不齐的后果。为促进近端胃切除消化道重建的规范化实施，从而提高近端胃切除术的临床疗效，降低术后并发症发生率，本文针对在《近端胃切除消化道重建中国专家共识（2020版）》中专家推荐率最高的双通道吻合、食管管型胃吻合、食管残胃侧壁吻合（side overlap）和双肌瓣吻合（double flaps）4种消化道重建方式，从适应证选择、手术步骤及技术要点分别进行阐述，以期为施行近端胃切除消化道重建的质量化控制提供参考。 With the increasing incidence of esophagogastric junction carcinoma, the application rate of proximal gastrectomy has been rising annually. There is a wide variety of methods for digestive tract reconstruction after proximal gastrectomy, and some of these reconstruction methods have been introduced relatively recently, with limited clinical experience, which led to a lack of standardization. Such a situation will inevitably result in inconsistent clinical outcomes of proximal gastrectomy with digestive tract reconstruction. To promote the standardization of digestive tract reconstruction after proximal gastrectomy, improve the clinical efficacy of proximal gastrectomy, and reduce the occurrence of postoperative complications, this article elaborates on the indications, surgical steps and technical points of the four methods after proximal gastrectomy recommended by the "Chinese consensus on digestive tract reconstruction after proximal gastrectomy (2020 edition)", such as double tract, side overlap, double flaps and gastric tube reconstruction, providing guidance for the application of digestive tract reconstruction after proximal gastrectomy.

    胃肿瘤近端胃切除消化道重建质量化控制

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    局部进展期胃癌根治术后围术期管理的质量化控制

    李乐平张荣华商亮卜建红...
    158-162页
    查看更多>>摘要：胃癌是我国常见的恶性肿瘤。多数胃癌患者就诊时已处于局部进展期，根治性手术是治疗胃癌的主要手段。术后围手术期管理的质量化控制在提高手术治疗效果和患者生活质量等方面具有重要意义。术后围手术期管理包括饮食与营养管理、抗菌药物管理、疼痛管理、预防性抗凝管理、气道管理、术后并发症管理以及出院与随访管理等7个方面。针对这几个方面建立明确的质量化标准，规范围手术期药物使用、预防和避免术后并发症的发生，才能达到减少住院时间和住院费用的目的，从而减轻患者负担，提高医疗机构的经济效益和社会效益。 Gastric cancer is a common malignant tumor in China. Most gastric cancer patients are already in the locally advanced stage when they seek medical treatment. Radical surgery is the main treatment for gastric cancer. The quality control of postoperative perioperative management is of great significance in improving the surgical treatment effect and the quality of life of patients. This article systematically summarizes seven aspects, including diet and nutrition management, antimicrobial drug management, pain management, prophylactic anticoagulation management, airway management, postoperative complication management, and discharge and follow-up management, establishes clear quality standards, and achieves the goals of reducing postoperative complications, standardizing perioperative medication use, reducing hospitalization time and costs, thereby reducing patient burden and improving the economic and social benefits of medical institutions.

    胃肿瘤,进展期胃癌根治术围手术期管理质量控制

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    胃癌术后标本规范化外科处理的质量化控制

    胡文庆崔鹏宋东阳卜建红...
    163-166页
    查看更多>>摘要：胃癌是我国常见的恶性肿瘤之一。以手术为主的综合治疗仍然是目前胃癌治疗的主要方式。胃癌术后标本的外科处理作为胃癌规范化诊疗的重要环节，近年来逐渐引起了国内外学者的重视。随着《胃癌根治术标本规范淋巴结送检及操作中国专家共识》（2019版）、《胃癌根治术标本的规范化外科处理中国专家共识》（2022 版）的相继推出，国内部分中心也陆续开展了胃癌术后标本的规范化外科处理，但由于对共识的理解深度及执行程度的差异，导致该项工作的开展质量参差不齐。本文就胃癌术后标本外科处理的各个环节的质量控制进行阐述，以期能够更好地使胃癌术后标本规范化外科处理的理念和技术进一步普及和推广，并且在实践中得到不断完善，从而推动我国胃癌外科高质量发展。 Gastric cancer is one of the most common malignant tumors in China. Currently, the surgery-based procedure is still the most acceptable strategy for treating gastric cancer. As an important part of standardized management, appropriate specimen processing following surgery is receiving more and more attention across the world. With the release of guidelines and consensus on the specimens processing after gastric cancer surgery, several centers in China have started to follow this standard procedure. However, due to differences in understanding the consensus and the degree of surgery practice, the results are variable. This paper will focus on reviewing every aspect of the processing procedure, with the hope that the concept and skill involved can be popularized in clinical operations. Hopefully this will help promote the development of high-quality gastric cancer surgery in China.

    胃肿瘤手术标本外科处理质量化控制

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    胃窦部癌No.12b淋巴结转移的临床病理因素及临床意义研究

    张宝郑国良张勇赵岩...
    167-174页
    查看更多>>摘要：目的 探讨胃窦部癌No.12b淋巴结（微）转移的相关临床病理因素及其清扫的临床意义。 方法 本研究采用回顾性队列研究方法。收集2007年1月至2012年12月期间，于辽宁省肿瘤医院胃外科接受胃癌根治术（至少D2根治范围）+No.12b淋巴结清扫、无远处转移、随访资料完整且未接受术前抗肿瘤治疗或伴有其他恶性肿瘤（史）的242例胃腺癌病例资料。鉴于胃癌淋巴结存在微转移的可能性，本研究应用抗体细胞角蛋白（CK）8/18进行免疫组织化学（免疫组化）检测患者No.12b淋巴结微转移情况。若患者苏木精-伊红（HE）染色和（或）CK8/18免疫组化结果为No.12b阳性，判定为No.12b（微）转移，纳入No.12b阳性组；反之则纳入No.12b阴性组。观察No.12b（微）转移情况，比较No.12b阳性和阴性两组患者的临床病理特征和5年无复发生存（RFS）情况，并进行相关危险因素分析。 结果 传统HE染色显示，242例胃腺癌患者中No.12b淋巴结阳性15例，阴性227例。共计241枚阴性No.12b淋巴结，免疫组化检测发现，其中7枚为No.12b淋巴结微转移阳性，微转移淋巴结检出率2.9%（7/241），且7枚分布于阴性病例中的不同病例，微转移率为3.1%（7/227）。据微转移结果进行重新分组：No.12b阳性组22例，占9.1%（22/242）；No.12b阴性组220例，占90.9%（220/242）。多因素分析显示，No.12b淋巴结（微）转移与胃壁浆膜受侵越严重（HR=3.873，95%CI：1.676~21.643，P=0.006）、T3分期（HR=1.615，95%CI：1.113~1.867，P=0.045）、N分期越高（HR=1.768，95%CI：1.187~5.654，P=0.019）、TNM分期中Ⅲ期（HR=2.129，95%CI：1.102~3.475，P=0.046）以及No.1、No.8a、No.12a淋巴结转移有关（HR=0.451，95%CI：0.121~0.552，P=0.035；HR=0.645，95%CI：0.071~0.886，P=0.032；HR=1.512，95%CI：1.381~2.100，P=0.029）。生存分析显示，与No.12b阴性组相比，No.12b阳性组患者的5年RFS更差（18.2%比34.5%，P<0.001）。其中，原发肿瘤的分化越差（HR=0.528，95%CI：0.288~0.969，P=0.039）、浆膜受侵越严重（HR=1.262，95%CI：1.039~1.534，P=0.019）、T分期、N分期和TNM分期越高（HR=4.880，95%CI：1.909~12.476，P<0.001；HR=2.332，95%CI：1.640~3.317，P<0.001；HR=0.139，95%CI：0.027~0.713，P=0.018）以及No.12a和No.12b淋巴结转移（HR=0.698，95%CI：0.518~0.941，P=0.018；HR=0.341，95%CI：0.154~0.758，P=0.008）是影响RFS的独立预后因素。 结论 微转移检测可以提高淋巴结的检出阳性率。对于胃窦癌，术中探查发现肿瘤侵及浆膜、胃周淋巴结转移较多、No.1、No.8a、No.12a淋巴结可疑转移时，行No.12b淋巴结清扫可能有助于改善患者预后。 Objective To investigate the clinicopathological factors and clinical significance of (micro)metastasis in No.12b lymph node in patients with gastric antrum cancer. Methods This was a retrospective cohort study of data of 242 patients with gastric adenocarcinoma without distant metastasis, complete follow-up data, and no preoperative anti-tumor therapy or history of other malignancies. All study patients had undergone radical gastrectomy (at least D2 radical range) + No.12b lymph node dissection in the Department of Gastric Surgery of Liaoning Cancer Hospital from January 2007 to December 2012. Immunohistochemical staining with antibody CK8/18 was used to detect micrometastasis to lymph nodes. Patients with positive findings on hematoxylin and eosin stained specimens and/or CK8/18 positivity in No.12b lymph node were diagnosed as having No.12b (micro)metastasis and included in the No.12b positive group. All other patients were classified as 12b negative. We investigated the impact of No.12b (micro)metastasis by comparing the clinicopathological characteristics and recurrence free survival (RFS) of these two groups of patients and subjecting possible risk factors to statistical analysis. Results Traditional hematoxylin-eosin staining showed that 15/242 patients were positive for No.12b lymph nodes and 227 were negative. A total of 241 negative No. 12b lymph nodes were detected. Immunohistochemical testing revealed that seven of these 241 No.12b lymph nodes (2.9%) were positive for micrometastasis. A further seven positive nodes were identified among the 227 nodes (3.1%) that had been evaluated as negative on hematoxylin–eosin-stained sections. Thus, 22 /242 patients' (9.1%) No.12b nodes were positive for micrometastases, the remaining 220 (90.9%) being negative. Factor analysis showed that No.12b lymph node (micro) metastasis is associated with more severe invasion of the gastric serosa (HR=3.873, 95%CI: 1.676-21.643, P=0.006), T3 stage (HR=1.615, 95%CI: 1.113-1.867, P=0.045), higher N stage (HR=1.768, 95%CI: 1.187-5.654, P=0.019), phase III of TNM stage (HR=2.129, 95%CI: 1.102-3.475, P=0.046), and lymph node metastasis in the No.1/No.8a/No.12a groups (HR=0.451, 95%CI: 0.121-0.552, P=0.035 HR=0.645, 95%CI:0.071-0.886, P=0.032 HR=1.512, 95%CI: 1.381-2.100, P=0.029, respectively). Survival analysis showed that the 5-year RFS of patients in the No.12b positive group was worse than that of those in the No.12b negative group (18.2% vs. 34.5%, P<0.001). Independent predictors of RFS were poorer differentiation of the primary tumor (HR=0.528, 95%CI:0.288-0.969,P=0.039), more severe serous invasion (HR=1.262, 95%CI:1.039-1.534, P=0.019), higher T/N/TNM stage (HR=4.880, 95%CI: 1.909-12.476, P<0.001 HR=2.332, 95%CI: 1.640-3.317,P<0.001 HR=0.139, 95%CI: 0.027-0.713,P=0.018, respectively), and lymph node metastasis in the No.12a/No.12b group(HR=0.698, 95%CI:0.518-0.941,P=0.018 HR=0.341, 95%CI:0.154-0.758,P=0.008, respectively). Conclusion Detection of micrometastasis can improve the rate of positive lymph nodes. In patients with gastric antrum cancer, dissection of group No.12b lymph nodes may improve the prognosis of those with intraoperative evidence of tumor invasion into the serosa, more than two lymph node metastases, and suspicious lymph nodes in groups No.1 / No.8a / 12a.

    胃肿瘤,胃窦部淋巴结清扫第12b组淋巴结微转移细胞角蛋白8/18预后

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