STUDY OF LYMPHATIC FLOW AND LYMPH NODE METASTASIS FROM No.3 AND No.6 LYMPH NODE IN GASTRIC CANCER

We studied the lymphatic flow drained from No. 3 and No. 6 lymph nodes around the stomach by observing stained rate of regional lymph nodes which were blackened by injecting activated carbon particles (CH40) into those lymph nodes at operation in cases of gastric cancer. Further, we analysed pattern of lymph node metastasis in cases of gastric cancer which had only No. 3 or only No. 6 metastasis in lymph nodes of the first group and compared the lymphatic flow drained from No. 3 and No.6. The main lymphatic flow drained from No. 3 streamed through Nos. 7, 9 and 8a, and in cases with only No. 3 metastasis, lymph node metastatic rate of the second or third group was high in Nos. 7, 9 and 8a. Metastatic pattern from metastasized No. 3 was similar to the route of lymphatic flow streamed from No. 3. Stained rate of regional lymph nodes by injected CH40 into No. 6 was high in Nos. 14v (56.7%), 8a (30.0%) and 9 (26.6%). In cases which had only No. 6 metastasis, lymph node metastatic rate of the second or third group was high in No. 8a (28.9%) and No. 9 (18.4%), although metastatic rate in No. 14v which had the most highest stained rate was low (9.1%). Metastatic pattern from metastasized No. 6 was not similar to the route of the lymphatic flow drained from No. 6. Multiple pathways of lymphatic stream from No. 6 may have caused discrepancy of lymphatics and pattern of lymph node metastasis.