中文摘要：

背景与目的：淋巴结转移是胰腺癌主要的转移方式，也是影响胰腺癌手术治疗疗效和预后的重要因素之一。本文研究胰头癌淋巴结转移的特性及临床病理特点，为胰头癌淋巴引流和进行术中淋巴结清扫提供依据。方法：借助手术显微镜解剖和检出胰头癌根治手术标本中的淋巴结，常规制作石蜡切片HE染色光镜下检测淋巴结有无肿瘤转移。总结并分析了胰头癌根治手术后的淋巴结转移及临床病理特点，通过矿检验分析淋巴结转移与临床分期、肿瘤大小、病理类型以及有无神经浸润等的相关性。结果：132例胰头癌根治性胰十二指肠切除术标本中，术后检出淋巴结转移发生率为59．85％（79／132），尤以第13、14、16、12、8组淋巴结转移发生频率较高。有第16组有淋巴结转移的14例患者，转移淋巴结多属16b1~组，主要分布于腹主动脉、下腔静脉和左。肾静脉围成的三角形区域内。有10例胰头癌仅发生第14组淋巴结转移而不伴第13或17组淋巴结转移。χ2检验显示与胰头癌淋巴结转移密切相关的病理因素有：肿瘤分化程度、肿瘤分期（T）和神经浸润。结论：胰头癌淋巴结转移发生的范围广、发生频率高，以第13、14、16、17、12、8组为主，对相关淋巴结累及的区域进行淋巴结清扫有可能提高胰腺癌手术的根治性。

英文摘要：

Background and purpose： Lymph node metastasis is a major metastatic mode of pancreatic cancer, which directly affects therapeutic efficiency and prognosis of pancreatic cancer. This study investigated the clinico-pathological characteristics and influencing factors of the lymph node metastasis of pancreatic head carcinoma, to provide a basis for rational strategy in surgical procedure. Methods： The clinico-pathological characteristics and the influencing factors of lymph node metastasis of 132 patients with pancreatic head carcinoma were analyzed retrospectively. The lymph nodes of the species of pancreaticoduodenectomy for pancreatic head carcinoma were dissected by method of operative microscope. The chi-square test was conducted to analyze the relationship between lymph node metastasis and the clinico-pathological factors. Results： A total of 132 cases with pancreatic head carcinoma underwent the surgical procedure of pancreaticoduodenectomy. The incidence rate of lymph node metastasis was 59.85% （79/132） in cases of pancreatic head carcinoma. The most common involved lymph node stations were No.13, No.14, No.16, No.12 and No.8 groups. The involved No.16 group lymph nodes in para-aortic region almost located within the triangular region surrounded by the abdominal aorta, inferior vena-cava and left renal vein. Ten pancreatic cancer derived from the uncinate process only had superior mesenteric vessel lymph nodes metastasis without involvement of post pancreatoduodenal lymph nodes. Lymph node metastasis of pancreatic head carcinoma was associated with tumor differentiation, tumor stage （T）, and tumor neural invasion by the statistic analysis of chisquare test （P〈0.05）. Conclusion： The lymph node metastasis of pancreatic head carcinoma occurs in a vast range and usually has a high incidence rate, especially in the lymph nodes of No.13, No.14, No.16, No.12 and No.8 groups. It was inferred that regional extended lymphadenectomy may improve the effectiveness of surgical treatment for pancreati