CAJ | 학술논문

目的：探讨结肠脾曲远端结直肠癌中枢方向 D3术式的必要性。方法：对2007-2008年收治的39例结肠脾曲远瑞结直肠癌患者中枢方向淋巴结转移及 CK20免疫组化淋巴结微转移状况及生存等因素进行分析。结果：10.26%（4/39）的患者发生了 N3站淋巴结转移；17.95%（7/39）的患者发生了 N3站淋巴结微转移；肿瘤浸润肠腔＞1/3周、合并原发灶外癌结节、Dukes 分期越高的患者易于出现高站别淋巴结微转移，发生高站别淋巴结微转移的患者预后不良。结论：CK20免疫组化淋巴结微转移检测简便、易行，优于 HE 染色；结直肠癌中枢方向行 D3术式有临床意义。
목적：탐토결장비곡원단결직장암중추방향 D3술식적필요성。방법：대2007-2008년수치적39례결장비곡원서결직장암환자중추방향림파결전이급 CK20면역조화림파결미전이상황급생존등인소진행분석。결과：10.26%（4/39）적환자발생료 N3참림파결전이；17.95%（7/39）적환자발생료 N3참림파결미전이；종류침윤장강＞1/3주、합병원발조외암결절、Dukes 분기월고적환자역우출현고참별림파결미전이，발생고참별림파결미전이적환자예후불량。결론：CK20면역조화림파결미전이검측간편、역행，우우 HE 염색；결직장암중추방향행 D3술식유림상의의。
Objective:To investigate the necessity for D3 resection in central direction for patients with colorectal cancer beneath the splenic flexure. Methods:Analyze lymph nodes metastasis and CK20 immune-histochemistry positive lymph nodes micro-metastasis in 39 patients with colorectal cancer which is beneath the splenic flexure.Results:10.26%(4/ 39)of the patients presented N3 stage lymph nodes metastasis;17.25%(7/ 39) of the patients presented N3 stage lymph nodes micro-metastasis;tumor invasion circle proportion in intestine cavity more than 1/ 3,with tumor nodes outside the tumor,higher stage of Dukes classification,thse patients were more prone to present highly staged lymph nodes micro-metastasis,which indicated poorer prognosis.Conclusion:CK20 immune-histochemistry assay which was used to detect lymph nodes micro-metastasis was more convinient and feasible than traditional H-E staining,to perform D3 resection in colorectal cancer which is beneath the splenic flexure was of clinical siginificance.