直肠癌淋巴结转移规律及其影响因素
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车向明, Email: chexiang@mail.xjtu.edu.cn

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Regularity of rectal lymph node metastasis and its influencing factors
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    目的:探讨直肠癌淋巴结转移规律与临床病理因素之间的关系。 方法:收集西安交通大学医学院第一附属医院1年来行直肠癌根治性手术切除的105例标本,解剖并分组收集淋巴结,逐枚进行病理组织学检查,计算各组淋巴结转移率,分析其与患者性别、年龄、肿瘤大小、肿瘤位置、分化程度、浸润深度、大体类型及至肛缘距离等的关系。 结果:105例患者共检出淋巴结2 211枚,平均每例21.06枚;淋巴结转移阳性45例,转移率为42.86%;肠旁淋巴结、系膜淋巴结、肠系膜下动脉根部淋巴结转移率分别为38.10%,28.85%和15.79%;淋巴结转移率与肿瘤大体类型、分化程度、浸润深度及至肛缘距离有关(P<0.05)。 结论:直肠癌淋巴结转移与肿瘤大体类型、分化程度、浸润深度及至肛缘距离有关,实施根治手术时,应在综合临床病理因素的基础上,合理选择淋巴结清扫范围。

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    Objective: To investigate the regularity of rectal lymph node metastasis and its relations with the clinicopathlogic factors. Methods: One hundred and five specimens from rectal cancer radical resection performed in the first affiliated hospital to Medical College of Xi’an Jiaotong University during one year were collected. The lymph nodes were dissected and collected in groups, and histopathological examination was performed in each resected lymph node. The metastatic rate of each group was calculated and the relationships between lymph node metastasis and clinicopathologic factors of the patients such as gender, age, tumor size, tumor location, differentiation degree, infiltration depth, gross tumor type and the distance from the anal verge were analyzed. Results: A total of 2 211 lymph nodes was detected from the 105 cases with an average of 21.06 lymph nodes per case. Positive lymph node metastasis was identified in 45 cases (42.86%), and the metastatic rate in perirectal lymph nodes, mesenteric lymph nodes and the lymph nodes at the root of inferior mesenteric artery was 38.10%, 28.85% and 15.79%, respectively. Rectal lymph node metastasis was related to the gross tumor type, differentiation degree, infiltration depth and distance from the anal verge (P<0.05). Conclusion: Rectal lymph node metastasis is associated with the gross tumor type, differentiation degree, infiltration depth and distance from the anal verge. Appropriate lymph node dissection range should be selected on the basis of the comprehensive analysis of the clinicopathologic factors when performing radical resection for rectal cancer.

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甘建新||车向明|李海军|李宇杰|廖新华|毕铁强|张丹杰.直肠癌淋巴结转移规律及其影响因素[J].中国普通外科杂志,2012,21(10):1201-1204.
DOI:10.7659/j. issn.1005-6947.2012.10.004

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  • 收稿日期:2011-11-16
  • 最后修改日期:2012-04-18
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  • 在线发布日期: 2012-10-15