胃癌病人大网膜转移率的初步探索（Dragon 05临床预试验）

摘要/Abstract

摘要：目的：本研究拟探究胃癌大网膜转移率。方法：收集2020年5月于上海瑞金医院接受胃癌根治术的病人信息，分析病人的临床病理特征及大网膜转移的危险因素，分析病人的复发及生存情况。结果：本研究共纳入59例胃癌病人。2例（3.4%）存在大网膜转移。1例术后病理分期为pT4aN3bM0，另1例新辅助治疗后术后病理分期为ypT4bN1M0。纳入研究的病人3年总生存率为87.9%。结论：胃癌大网膜转移率较低，且大网膜转移的病理分期偏晚。为进一步验证该临床问题，应开展联合大网膜切除与保留大网膜的胃癌根治术两组之间的临床前瞻性随机对照研究。

关键词:胃癌,大网膜,手术

Abstract:

ObjectiveTo investigate the rate of greater omentum metastasis in gastric cancer(GC).MethodsGeneral informations of patients with GC who underwent radical gastrectomy at Shanghai Ruijin Hospital in May 2020 were collected, and their clinicopathological characteristics were analyzed to find risk factors of greater omentum metastasis. Recurrence and survival were also assessed.ResultsA total of 59 patients with GC were included in the study, of which 2(3.4%) had greater omentum metastasis. One patient presented a pathological stage of pT4aN3bM0 and another ypT4bN1M0. The 3-year overall survival rate of patients in the study was 87.9%.ConclusionsThe rate of greater omentum metastasis was relatively low, and patients with greater omentum metastasis had an more advanced pathological stage. To further validate this clinical issue, a prospective randomized controlled clinical study should be conducted between radical gastrectomy with omentectomy and omentum-preserving radical gastrectomy.

Key words:Gastric cancer,Greater omentum,Surgery

中图分类号:

R735.2

华子辰, 梅郁, 李琛, 严超, 燕敏, 朱正纲, 姚学新. 胃癌病人大网膜转移率的初步探索（Dragon 05临床预试验）[J]. 外科理论与实践, 2025, 30(01): 41-46.

HUA Zichen, MEI Yu, LI Chen, YAN Chao, YAN Min, ZHU Zhenggang, YAO Xuexin. Preliminary exploration of greater omentum metastasis rate in patients with gastric cancer: clinical pilot study of Dragon 05 trial[J]. Journal of Surgery Concepts & Practice, 2025, 30(01): 41-46.

图/表2

图1

表1

病人一般资料和临床病理特征[M(M1, M3)/n(%)]

Variables	Number（%）
Age（years）
Median（interquartile ranges）	63（33，86）
Gender
Male	41（69.5%）
Female	18（30.5%）
cT stage
T1-3	29（49.2%）
T4	30（50.8%）
cN stage
N0	34（57.6%）
N+	25（42.4%）
Tumor location
Cardia/fundus	5（8.5%）
Body	18（30.5%）
Pylorus/antrum	35（59.3%）
Linitis plastica	1（1.7%）
Tumor size（cm）
Median（interquartile ranges）	3（0.5，9）
Neoadjuvant therapy
Yes	8（13.6%）
No	51（86.4%）
Surgical access
Open	53（89.8%）
Laparoscopy	6（10.2%）
Type of gastrectomy
Distal	40（67.8%）
Total	19（32.2%）
Adjuvant chemotherapy
Yes	47（79.7%）
No	12（20.3%）
Histopathology type
Tubular adenocarcinoma	38（64.4%）
Signet ring cell carcinoma	5（8.5%）
Mixed adenocarcinoma	16（27.1%）
Differentiation degree
Differentiated	18（30.5%）
Undifferentiated	41（69.5%）
Greater omentum metastasis
Yes	2（3.4%）
No	57（96.6%）
Perineural invasion
Yes	28（47.5%）
No	31（52.5%）
Lymphovascular invasion
Yes	18（30.5%）
No	41（69.5%）
Pathological stage
Ⅰ	19（32.2%）
Ⅱ	15（25.4%）
Ⅲ	25（42.4%）
Tumor regression grade
0	0
1	1（12.5%）
2	7（87.5%）
3	0

表1

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