小淋巴结转移与结直肠癌分期和预后的关系

Effect of small lymph node metastasis on the staging and progno- sis of colorectal cancer

淋巴结转移是影响结直肠癌预后的重要因素。目前临床上对结直肠癌标本淋巴结检查没有统一的规范，对直径〈5mm的小淋巴结的检出和转移状况不重视。而传统的淋巴结检查方法，对小淋巴结漏检的可能性极大。多个研究表明：小淋巴结中不仅存在转移，且其占阳性淋巴结总数的50％以上。小淋巴结的检出精确了结直肠癌患者的病理分期，有利于术后正确辅助治疗方案的选择。临床上应改进结直肠癌标本淋巴结检查方法，提高小淋巴结的检出率。

Lymph node metastasis is an important prognostic factor in patients with colorectal cancer. The deiameter of lymph node less than 5mm （small lymph node） is probably ignorect by the conventional manual method, and many patients would have been understaged. The fat-clearing method makes it possible to identify lymph nodes smaller than 5 mm in maximum diameter and to detect small metastatic nodes that would be ignored by the conventional manual method. Several studies have shown that the majority of metastatic lymoph nodes detected after curative colorectal resection are less than 5 mm in diameter. The detection of small lymph node ionprovethe accuracy of colorectal cancer staging. We should improve the method of detecting lymph node to ionprove the detectable rate of small lymph node. A significant number of patients will be upstaged and benefit from the adjuvant therapy.