Features of lymph node metastasis In 50 cases of pancreatic ductal adenoma in the head

Objective To explore the lymphatic flow in the head of pancreas and investigate the characteristics of lymph nodes metastasis to provide theoretical evidence of the extent of radical lymph nodes resection in surgical procedure for pancreatic head carcinoma. Methods All the lymph nodes in specimens of pancreatic head carcinoma from 50 cases after radical pancreaticoduodenectomy were found out with the help of surgical microscope. Then the metastatic lymph nodes were diagnosed by pathological examination and the metastasis in different groups of lymph nodes and its relationship with the size and differentiation of the tumor were analyzed. Results A total of 1916 lymph nodes were found in 50 specimens of regional pancreaticoduodenectomy, with an average of 38.3 per patient. According to HE staining, 35 of 50 patients and 210 of 1916 lymph nodes were found to be metasta-sis. Metastasis was found in group 13, 14, 17 and 8 lymph nodes. Group 14 metastasis was more commonly happened in the cases of pancreatic uncinate carcinoma. Group 16 was found to have the highest frequency (12%) of metastasis in all lymph nodes of the third station. Conclusion The inci-dence of lymph nodes metastasis in pancreatic carcinoma is high and the regional lymph nodes dissec-tion is necessary in radical pancreaticoduodenectomy. The lymph nodes around the superior mesenteric vessel are the main targets, and those in the triangular region arrounded by abdominal aorta,inferior vena cava and left renal vein should be paid more attention. Key words: Pancreatic neoplasms;  Lymph node metastasis