CAJ | 학술논문

目的：探讨淋巴结转移度（LNR）对结直肠癌术后远处转移的预测价值。方法回顾性分析解放军总医院普通外科2007年1月~2012年1月行根治性切除手术的180例结直肠癌患者的临床资料，按照术后有无出现远处转移将患者分为非转移组和转移组，分析LNR与结直肠癌术后出现远处转移的关系。结果非转移组118例（65.6%）；转移组62例（34.4%），其中肝转移39例，肺转移12例，骨、肺及多脏器转移11例。两组在肿瘤大体类型、分化程度、检出淋巴结总数及LNR方面差异有统计学意义（P<0.05），溃疡型和浸润型较隆起型，低分化程度较高、中分化程度，LNR≥0.17较LNR<0.17结直肠癌更易发生远处转移；多因素分析结果显示LNR与分化程度及大体类型均是影响结直肠癌术后远处转移的独立相关因素（RR：2.098；CI%：1.050-4.192；P=0.036）。结论 LNR与结直肠癌术后发生远处转移独立相关，可联合分化程度等作为评估结直肠癌术后发生远处转移及预后的参考指标。
목적：탐토림파결전이도（LNR）대결직장암술후원처전이적예측개치。방법회고성분석해방군총의원보통외과2007년1월~2012년1월행근치성절제수술적180례결직장암환자적림상자료，안조술후유무출현원처전이장환자분위비전이조화전이조，분석LNR여결직장암술후출현원처전이적관계。결과비전이조118례（65.6%）；전이조62례（34.4%），기중간전이39례，폐전이12례，골、폐급다장기전이11례。량조재종류대체류형、분화정도、검출림파결총수급LNR방면차이유통계학의의（P<0.05），궤양형화침윤형교륭기형，저분화정도교고、중분화정도，LNR≥0.17교LNR<0.17결직장암경역발생원처전이；다인소분석결과현시LNR여분화정도급대체류형균시영향결직장암술후원처전이적독립상관인소（RR：2.098；CI%：1.050-4.192；P=0.036）。결론 LNR여결직장암술후발생원처전이독립상관，가연합분화정도등작위평고결직장암술후발생원처전이급예후적삼고지표。
Objective To investigate the predictive value of metastatic lymph node ratio for postoperative distant metastasis in patients with colorectal cancer. Methods The clinicopathological data were collected from 180 patients with colorectal cancer who underwent surgical resection in General Hospital of PLA between from January, 2007 to January, 2012. The patients were divided into 2 groups according to the presence of distant organ metastasis and the clinicopathological factors were analyzed with Chi-square test and logistic regression. Results Of the 118 surgical patients enrolled, 118 were free of distant metastasis and 62 had distant metastasis involving the liver (39 cases), lungs (12 cases), and multiple organs (11 cases). The gross types, differentiation, ELN and LNR of the tumors differed significantly between the two groups. Logistic regression analysis showed that LNR was an independent factor correlating to distant metastasis of colorectal cancer. Conclusion LNR is independently correlated with distant organ metastasis of colorectal cancer and serves as an important predicative factor for estimating the prognosis of colorectal cancer.