CAJ | 학술논문

目的了解肌层侵犯膀胱癌的病理分级分期与淋巴结转移的关系及不同分期阳性淋巴结的分布状况.方法回顾性分析2006年1月1日至2009年7月31日行根治性膀胱切除的208例膀胱移行上皮细胞癌连续病例.男182例,女26例.平均年龄65岁.统计分析肿瘤淋巴结转移和病理特点的关系. 结果 208例中,根据WHO 1973年分级标准,G_2 55例(26.4%)、G_3 153例(73.6%),病理分期T_1 59例(28.4%)、T_2 58例(27.8%)、T_3 48例(23.0%)、T_4 43例(20.6%).病理分级和分期呈正相关,r=0.392,P<0.001.其中行淋巴清扫151例,T_3、T_4淋巴结阳性比例显著高于T_1病例(P=0.001,P=0.000),而T_4淋巴结阳性比例显著高于T_2病例(P=0.012).阳性淋巴结主要分布在盆腔区域淋巴结.G_2肿瘤淋巴结阳性1例(1.8%),G_3 38例(24.8%).随着病理分期增加,近端大血管周围淋巴结受累机会也随之升高. 结论对于低分级分期肿瘤,由于淋巴结受累机会相对小,可以选择盆腔区域淋巴清扫;而对于高分级分期肿瘤,扩大淋巴清扫范围是必要的.
목적 료해기층침범방광암적병리분급분기여림파결전이적관계급불동분기양성림파결적분포상황.방법 회고성분석2006년1월1일지2009년7월31일행근치성방광절제적208례방광이행상피세포암련속병례.남182례,녀26례.평균년령65세.통계분석종류림파결전이화병리특점적관계. 결과 208례중,근거WHO 1973년분급표준,G_2 55례(26.4%)、G_3 153례(73.6%),병리분기T_1 59례(28.4%)、T_2 58례(27.8%)、T_3 48례(23.0%)、T_4 43례(20.6%).병리분급화분기정정상관,r=0.392,P<0.001.기중행림파청소151례,T_3、T_4림파결양성비례현저고우T_1병례(P=0.001,P=0.000),이T_4림파결양성비례현저고우T_2병례(P=0.012).양성림파결주요분포재분강구역림파결.G_2종류림파결양성1례(1.8%),G_3 38례(24.8%).수착병리분기증가,근단대혈관주위림파결수루궤회야수지승고. 결론 대우저분급분기종류,유우림파결수루궤회상대소,가이선택분강구역림파청소;이대우고분급분기종류,확대림파청소범위시필요적.
Objective To describe the distribution of positive lymph nodes of muscle invasive bladder cancer, and explore the relationship between positive nodes and pathological characters. Methods Pathological data from 208 consecutive cases of muscle invasive bladder cancer were collect-ed and reviewed. The correlation of tumor grade, tumor stage and lymph nodes status was analyzed. The locations and numbers of positive nodes were recorded and compared according to the specific grade or stage. Results There were 153 cases (73.6%)of G_3 tumor and 55 cases(26.4%) of G_2 tumor and none G_1 (0%)in this cohort. The case number from pT1 to pT4 was 59(28. 4%)、58 (27.8%)、48(23.0%)and 43(20.6%), respectively. The tumor grade was positively correlated with tumor stage in this cohort (r=0. 392, P=0. 000). 153 cases had been taken lymph node dissection. There was more node positive cases in pT_3 and pT_4 than that in T_1 (P=0. 001 ,P=0. 000), as well as pT_4 compared with pT_2 (P= 0. 012). The data showed that most of the positive nodes were located within the pelvic region. There was only 1 case and 1 node positive for G_1/G_2 tumor with 24.84% of node positive cases for G_3. The positive nodes involved from pelvic to proximal artery while the stage increased. Conclusions There is less chance for low grade (G_1/G_2) bladder cancer to be node posi-tive compared with G_3 ones. It is necessary to take a extensive lymphadenectomy for the patients with stage more than T_2.