CAJ | 학술논문

目的探讨结直肠神经内分泌肿瘤淋巴结转移特点及其相关的影响因素.方法回顾性分析宁波市鄞州人民医院和宁波市医疗中心李惠利医院1997年6月至2012年12月间收治的63例结直肠神经内分泌肿瘤患者的临床病理资料,观察淋巴结转移的特点.分类资料的比较以及淋巴结转移危险性的单因素分析采用x2检验,多因素分析采用Logistic回归分析.结果 63例患者区域淋巴结转移率为30％(19/63),其中转移至肠旁淋巴结者占58％(11/19),转移至肠系膜淋巴结者占26％(5/19),转移至肠系膜根部中央组淋巴结者占16％ (3/19).未发现中央组以远的淋巴结转移以及跳跃式转移现象.单因素分析显示:瘤体大小、浸润深度、黏膜面溃疡形成、淋巴管浸润及WHO病理分级与区域淋巴结转移相关(均P＜0.01).多因素分析显示:瘤体大小、淋巴管浸润和病理分级是影响结直肠神经内分泌肿瘤淋巴结转移的独立危险因素(均P ＜0.05).结论瘤体较大、伴有淋巴管浸润或分级为G2、G3级的结直肠神经内分泌肿瘤具有较高的区域淋巴结转移率.根治性手术中应特别注意肠旁和肠系膜淋巴结的彻底性切除.
목적 탐토결직장신경내분비종류림파결전이특점급기상관적영향인소.방법 회고성분석저파시은주인민의원화저파시의료중심리혜리의원1997년6월지2012년12월간수치적63례결직장신경내분비종류환자적림상병리자료,관찰림파결전이적특점.분류자료적비교이급림파결전이위험성적단인소분석채용x2검험,다인소분석채용Logistic회귀분석.결과 63례환자구역림파결전이솔위30％(19/63),기중전이지장방림파결자점58％(11/19),전이지장계막림파결자점26％(5/19),전이지장계막근부중앙조림파결자점16％ (3/19).미발현중앙조이원적림파결전이이급도약식전이현상.단인소분석현시:류체대소、침윤심도、점막면궤양형성、림파관침윤급WHO병리분급여구역림파결전이상관(균P＜0.01).다인소분석현시:류체대소、림파관침윤화병리분급시영향결직장신경내분비종류림파결전이적독립위험인소(균P ＜0.05).결론 류체교대、반유림파관침윤혹분급위G2、G3급적결직장신경내분비종류구유교고적구역림파결전이솔.근치성수술중응특별주의장방화장계막림파결적철저성절제.
Objective To investigate the features and risk factors associated with lymph node metastasis in colorectal neuroendocrine neoplasm.Methods Clinical and pathological data of 63 patients with colorectal neuroendocrine neoplasm treated in Yinzhou People's Hospital between June 1997 to December 2012,were analyzed retrospectively.Comparisons of categorical data and univariate analysis of risk factors of lymph node metastasis were conducted by x2 test,multivariate analysis was conducted by Logistic regression analysis.Results Of the 63 patients the rate of regional lymph node metastasis was 30％ (19/63) with 58％ limited to para-intestinal lymph nodes in 11 cases,26％ limited to mesenteric lymph nodes in 5 cases,and 16％ limited to mesenteric root central lymph nodes in 3 cases.No metastasis exceeding central lymph nodes was observed.According to univariate analysis,tumor size,depth of invasion,ulceration in mucous membrane,invasion of lymphatic vessel and pathological grading suggested by WHO were related to regional lymph node metastasis (P ＜ 0.01).Multivariate regression analysis revealed that tumor size,invasion of lymphatic vessel and pathological grading were independent risk factors for lymph node metastasis in colorectal neuroendocrine neoplasm (P ＜ 0.05).Conclusions Colorectal neuroendocrine neoplasm with larger tumor size,invasion of lymphatic vessel or higher grade (G2,G3) has high risk of regional lymph node metastasis.