的 探讨进展期胃癌第10组淋巴结转移的预测方法。方法 回顾性分析北京肿瘤医院2006年1月至2009年12月行根治术并第10组淋巴结清除的142例胃癌患者的临床病理资料和Ki67、基质金属蛋白酶7（MMP7）、p53免疫组织化学结果，分析第10组淋巴结转移的危险因素。结果 全组患者淋巴结转移率为66.2%（94/142），第10组淋巴结转移率为16.2%（23/142）。单因素分析结果显示，第10组淋巴结转移与肿瘤部位、肿瘤大小、Bormann分型、浸润深度、第4s组淋巴结转移有关，而与分子标志物Ki-67、MMP7、p53的表达无关。多因素分析显示，第4s组淋巴结转移是第10组淋巴结转移的独立危险因素。第4s组淋巴结阴性者，第10组淋巴结转移率为7.8%；第4s组阳性者，第10组淋巴结转移率为26.6%。 结论 第4s组淋巴结转移是进展期胃癌第10组淋巴结转移的危险因素，但是尚不能将其阴性预测几率降至5%以下。我们不能有效预测第10组淋巴结阴性胃癌病例。

Objective To investigate the predictors of No.10 lymph nodes metastasis in patients with the advanced gastric cancer. Methods A retrospective study was performed to analyze 142 patients who underwent D2 curative proximal or total gastrectomy for gastric carcinoma from January 2006 to December 2009. Clinicopathological factors and molecular markers such as sex, age, location of the primary tumor, tumor sizes, gross type, depth of invasion, the metastasis of adjacent lymph node, Ki-67, matrix metalloproteinase(MMP)7, and p53 status were analyzed with univariate and multivariate analysis. Results The overall ratio of metastatic lymph node was 66.2% (94/142). The positive rates of No 10 lymph nodes were 16.2%(23/142). The No 10 lymph node metastasis was correlated with tumor site, size, Borrmann type, depth of invasion, and No4s lymph node metastasis but biomarkers Ki-67, MMP7 and p53. Multivariable logistic regression analysis showed that positive metastasis of No.4s lymph node was an independent risk factor for lymph node metastasis in No.10 lymph nodes. The positive rates of No.10 lymph nodes were 7.8% and 26.6% for the No4s lymph nodes negative patients and positive patients, respectively. Conclusion The status of No4s lymph nodes is an independent risk factor of No.10 lymph nodes metastasis in patients with advanced gastric cancer, but the negative predict value is not low enough to 5 percent. We can’t predict negative No.10 lymph nodes accurately in patients with advanced gastric cancer.