左、右半结肠癌淋巴结转移的差异

Difference of the lymph node metastasis between left and right colon cancer

目的探讨左、右半结肠癌淋巴结转移方式上的差异。方法结肠癌患者118例,其中行D2式淋巴廓清术者12例,D3式90例,D4式16例。用新鲜标本挤压触诊法行淋巴结检取。统计N1,N2,N3,N4站淋巴结的转移情况。结果左半结肠癌淋巴结转移率为33.8%,其中肠旁淋巴结转移率为28.0%,中枢方向淋巴结转移率为19.1%。右半结肠癌的淋巴结转移率为52.0%,其中肠旁淋巴结转移率为52.0%,中枢方向淋巴结转移率为38.0%。结论右半结肠癌肠旁淋巴结及中枢方向淋巴结的转移率均高于左半结肠癌。结肠癌的手术应以D3术式为基本术式,重点要清扫向中枢方向转移的淋巴结。

Objective To explore the differences of left and right colon cancer lymph node metastasis ways.Methods118 cases of patients with colon cancer,in which line D2-type dissection in 12 cases,D3-type 90 cases,D4-type in 16 cases were studied.Lymph node was examined by fresh specimens＇ compression and palpation.Lymph nodes at N1,N2,N3,N4 stations were statistized.ResultsLeft colon cancer lymph node metastasis rate was 33.8%,in which intestinal lymph node metastasis rate was 28.0%,and the central direction of lymph node metastasis rate was 19.1%.Right colon cancer lymph node metastasis rate was 52.0%,in which intestinal lymph node metastasis rate was 52.0%,and the central direction of lymph node metastasis rate was 38.0%.ConclusionThe right colon intestinal lymph nodes and the central direction of lymph node metastasis rate are higher than those of the left colon.Colon cancer surgery should be based on D3-type as the basic surgical technique,and we should be focus to clean the central direction of the transfer of lymph node.