中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2012年
3期
219-221
,共3页
直肠肿瘤%淋巴转移%结直肠外科手术%淋巴结切除术
直腸腫瘤%淋巴轉移%結直腸外科手術%淋巴結切除術
직장종류%림파전이%결직장외과수술%림파결절제술
Rectal neoplasms%Lymphatic metastasis%Colorectal surgery%Lymph node excision
目的 通过对直肠癌淋巴结跳跃转移的临床病理特点进行分析探讨直肠癌根治术高位血管结扎的意义.方法 回顾性分析2009年10月至2010年10月行根治性直肠癌切除的207例患者资料,观察肠系膜下动脉周围及其根部淋巴结发生跳跃转移的情况,分析临床病理因素与跳跃转移间的相关性.结果 207例直肠癌患者手术切除标本中共检出淋巴结2305枚,有转移的患者168例.跳跃转移与肿瘤的分化程度(x2=113.65,P=0.037)及肿瘤浸润深度(x2=108.22,P=0.042)相关,与性别、年龄、部位、大小、术前血清癌胚抗原水平、大体类型和组织类型因素均无明显相关性.结论 术前对直肠癌肿瘤分化程度及浸润深度进行评估,有助于提示是否存在淋巴结跳跃转移；对于有跳跃转移风险的患者应行血管高位结扎淋巴结清扫术.
目的 通過對直腸癌淋巴結跳躍轉移的臨床病理特點進行分析探討直腸癌根治術高位血管結扎的意義.方法 迴顧性分析2009年10月至2010年10月行根治性直腸癌切除的207例患者資料,觀察腸繫膜下動脈週圍及其根部淋巴結髮生跳躍轉移的情況,分析臨床病理因素與跳躍轉移間的相關性.結果 207例直腸癌患者手術切除標本中共檢齣淋巴結2305枚,有轉移的患者168例.跳躍轉移與腫瘤的分化程度(x2=113.65,P=0.037)及腫瘤浸潤深度(x2=108.22,P=0.042)相關,與性彆、年齡、部位、大小、術前血清癌胚抗原水平、大體類型和組織類型因素均無明顯相關性.結論 術前對直腸癌腫瘤分化程度及浸潤深度進行評估,有助于提示是否存在淋巴結跳躍轉移；對于有跳躍轉移風險的患者應行血管高位結扎淋巴結清掃術.
목적 통과대직장암림파결도약전이적림상병리특점진행분석탐토직장암근치술고위혈관결찰적의의.방법 회고성분석2009년10월지2010년10월행근치성직장암절제적207례환자자료,관찰장계막하동맥주위급기근부림파결발생도약전이적정황,분석림상병리인소여도약전이간적상관성.결과 207례직장암환자수술절제표본중공검출림파결2305매,유전이적환자168례.도약전이여종류적분화정도(x2=113.65,P=0.037)급종류침윤심도(x2=108.22,P=0.042)상관,여성별、년령、부위、대소、술전혈청암배항원수평、대체류형화조직류형인소균무명현상관성.결론 술전대직장암종류분화정도급침윤심도진행평고,유조우제시시부존재림파결도약전이；대우유도약전이풍험적환자응행혈관고위결찰림파결청소술.
Objective To analyze clinical and pathological of lymph node skip metastasis of rectal cancer and discuss the meaning of the high vascular ligation. Methods A retrospective analysis of 207 cases for radical resection of rectal cancer was made,meanwhile the skip metastasis of the roots of the inferior mesenteric artery lymph nodes was studied.Combined with clinical data,the relevance of clinical and pathological factors with the skip metastasis was analyzed.Results The 207 cases of rectal cancer patients surgical resection specimen detected 2305 pieces of lymph node,the transfer of 168 patients with.The statistical analysis found that skip metastasis related with tumor differentiation (x2 =113.65,P =0.037) and depth of tumor invasion ( x2 =108.22,P =0.042),but gender,age,location,size,preoperative carcinoembryonic antigen level, gross type and tissue types factors were not significantly correlation.Conclusions Preoperative differentiation of cancer and tumor invasion depth assessment can help prompt the existence of lymph node skip metastasis.The assessment of the risk of skip metastasis for patients should be performed the high vascular ligation and lymph node dissection.
