脂肪清除和脂肪变性技术处理直肠癌标本的比较

Comparison of fat clearance and fat lucidification in examining rectal cancer specimen

目的比较应用脂肪清除和脂肪变性技术在直肠癌标本寻找淋巴结的效果。方法收集2007年1月至12月问收治的64例直肠癌患者（男38例、女26例，平均年龄54岁）的手术标本，按手术时间的先后分为脂肪清除组（30例）和脂肪变性组（34例）．对比两组标本所获得的淋巴结总数及其大小和转移情况以及处理标本的时间。结果脂肪清除组标本检出淋巴结平均37．4（17～69）枚／例，其中转移淋巴结3．3枚／例，平均直径为3．6mm;脂肪变性组则平均检出36．2（18～62）枚／例，其中转移淋巴结3．2枚／例．平均直径为3．7nm。两组差异均无统计学意义（P〉0．05）。脂肪清除和脂肪变性两组预处理标本的时间分别为72和28h，脂肪变性组处理标本的时间明显短于脂肪清除组（P〈0．05）；寻找淋巴结的时间则分别为2．1和2．0h，两组差异均无统计学意义（P〉0．05）。结论脂肪变性技术处理直肠癌标本，不但可获得与脂肪清除技术同样的淋巴结数量．而且可明显缩短处理标本的时间。

Objective To compare fat clearance and fat lucidification in the examination of rectal cancer specimen, and to study the distribution pattern of lymph nodes in rectal cancer specimen. Method Between January 2007 and December 2007, sixty-four cases undergone total mesorectal excision were divided into two groups. The fat clearance technique was used to examine the specimens in one group, while fat lucidification was used in the other. The total number and the number of metastatic lymph nodes between two groups were compared, as well as the time for processing specimens and that for dissecting the lymph nodes. Results An average of 37.4 lymph nodes were detected with fat clearance, in which 3.3 lymph nodes were metastatic; while an average of 36.2 nodes were detected with fat lueidification, in which 3.2 were metastatic. There were no significant differences in either the total number or the number of metastatic lymph nodes. The time for processing specimens in the fat lucidification group was 28 hours, while in the fat clearance group was 72 hours. The time for specimen processing was significantly shorter in the fat lucidification group （P〈0.05）. The mean time for dissecting lymph nodes in the fat clearance group was 2.1 hours, while in the fat lucidification group was 2.0 hours, the difference was not statistically significant. Conclusion When processing rectal cancer specimens with the fat lucidification technique can result in the similar number of lymph nodes compared to the fat clearance technique, with significantly shorter sepcimen processing time. The spatial position of the lymph nodes is better preserved using the fat lucidification technique, which may help study the distribution pattern of the normal and metastatic lymph nodes.