中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
14期
1621-1624
,共4页
包向东%赵军超%卜贺启%潘海强%郁峰%沈燕%崔焌辉
包嚮東%趙軍超%蔔賀啟%潘海彊%鬱峰%瀋燕%崔焌輝
포향동%조군초%복하계%반해강%욱봉%침연%최준휘
直肠肿瘤%肿瘤分期%肿瘤转移%淋巴结%影响因素
直腸腫瘤%腫瘤分期%腫瘤轉移%淋巴結%影響因素
직장종류%종류분기%종류전이%림파결%영향인소
Rectal neoplasms%Neoplasms staging%Neoplasms metastasis%Lymph nodes%Influencing factors
目的：阐述T1和T2期直肠癌淋巴结转移规律及其影响因素，探讨直肠癌局部切除适应证。方法选择2002年1月-2012年12月浙江省立同德医院和浙江省海盐县中医院收治的并接受根治性手术的原发性T1和T2期直肠癌患者116例，回顾性分析其临床病理资料。结果本组116例直肠癌患者发生淋巴结转移24例，总淋巴结转移率为20.7％，T1、T2期患者淋巴结转移率分别为3.9％（2/51）、33.8％（22/65），T1期患者淋巴结转移率低于T2期患者（χ2＝15.595，P﹤0.001）。单因素分析结果显示，肿瘤大体类型（χ2＝6.839，P＝0.033）、组织类型（χ2＝7.756，P＝0.005）、分化程度（χ2＝46.039，P﹤0.001）和T分期（χ2＝15.595，P﹤0.001）与淋巴结转移有关。二分类多元Logistic回归分析发现，肿瘤分化程度（OR＝3.374）及T分期（OR＝6.727）对回归方程的影响有统计学意义（P﹤0.05）。结论肿瘤分化程度和浸润深度是T1、T2期直肠癌发生淋巴结转移的最主要影响因素，对分化程度较高的T1期直肠癌可考虑局部切除。
目的：闡述T1和T2期直腸癌淋巴結轉移規律及其影響因素，探討直腸癌跼部切除適應證。方法選擇2002年1月-2012年12月浙江省立同德醫院和浙江省海鹽縣中醫院收治的併接受根治性手術的原髮性T1和T2期直腸癌患者116例，迴顧性分析其臨床病理資料。結果本組116例直腸癌患者髮生淋巴結轉移24例，總淋巴結轉移率為20.7％，T1、T2期患者淋巴結轉移率分彆為3.9％（2/51）、33.8％（22/65），T1期患者淋巴結轉移率低于T2期患者（χ2＝15.595，P﹤0.001）。單因素分析結果顯示，腫瘤大體類型（χ2＝6.839，P＝0.033）、組織類型（χ2＝7.756，P＝0.005）、分化程度（χ2＝46.039，P﹤0.001）和T分期（χ2＝15.595，P﹤0.001）與淋巴結轉移有關。二分類多元Logistic迴歸分析髮現，腫瘤分化程度（OR＝3.374）及T分期（OR＝6.727）對迴歸方程的影響有統計學意義（P﹤0.05）。結論腫瘤分化程度和浸潤深度是T1、T2期直腸癌髮生淋巴結轉移的最主要影響因素，對分化程度較高的T1期直腸癌可攷慮跼部切除。
목적：천술T1화T2기직장암림파결전이규률급기영향인소，탐토직장암국부절제괄응증。방법선택2002년1월-2012년12월절강성립동덕의원화절강성해염현중의원수치적병접수근치성수술적원발성T1화T2기직장암환자116례，회고성분석기림상병리자료。결과본조116례직장암환자발생림파결전이24례，총림파결전이솔위20.7％，T1、T2기환자림파결전이솔분별위3.9％（2/51）、33.8％（22/65），T1기환자림파결전이솔저우T2기환자（χ2＝15.595，P﹤0.001）。단인소분석결과현시，종류대체류형（χ2＝6.839，P＝0.033）、조직류형（χ2＝7.756，P＝0.005）、분화정도（χ2＝46.039，P﹤0.001）화T분기（χ2＝15.595，P﹤0.001）여림파결전이유관。이분류다원Logistic회귀분석발현，종류분화정도（OR＝3.374）급T분기（OR＝6.727）대회귀방정적영향유통계학의의（P﹤0.05）。결론종류분화정도화침윤심도시T1、T2기직장암발생림파결전이적최주요영향인소，대분화정도교고적T1기직장암가고필국부절제。
Objective To discuss the rule of lymph node metastasis in T1 to T2 staging invasive rectal carcinoma and its influencing factor as well as the indication for local excision of rectal cancer. Methods 116 cases of T1 to T2 staging invasive rectal carcinoma were selected who were admitted to Tongde Hospital of Zhejiang Province and Haiyan County TCM Hospital and received surgical resection from January 2002 to December 2012. The clinical data of the cases were analyzed retrospectively. Results The rate of lymph node metastasis in T1 to T2 staging invasive rectal carcinoma was 20. 7% (24/116),and that rate in T1 and in T2 was 3. 9% ( 2/51) and 33. 8% ( 22/65),respectively,indicating higher rate in T1 than in T2( χ 2 = 15. 595,P ﹤0. 001). Univariate analysis showed that the massive type of the tumor(χ 2 =6. 839,P =0. 033),histology type (χ 2 =7. 756,P =0. 005),differentiating degree of the tumor(χ 2 =46. 039,P ﹤0. 001)and tumor T staging(χ 2 =15. 595, P ﹤0. 001)were influencing factors for lymph node metastasis. Multivariate Logistic regression analysis showed that the differentiating degree of the tumor(OR =3. 374)and tumor T staging(OR =6. 727)had statistically significant influence over the regression equation(P ﹤0. 05). Conclusion The differentiating degree of the tumor and the depth of tumor invasion were the most influencing factors for lymph node metastasis in T1 to T2 staging rectal carcinoma. T1 staging rectal carcinoma with higher degree of differentiation could be considered local excision.
