结直肠癌单个转移淋巴结分布情况及其影响因素

Solitary metastatic lymph node distribution and its influencing factors in colorectal cancer

目的研究结直肠癌单个转移淋巴结的分布情况,探讨结直肠癌前哨淋巴结(SLN)转移规律及其影响因素。方法收集广西医科大学第一附属医院结直肠肛门外科2008年9月至2011年11月行结直肠癌根治术后常规病理检测只有一个淋巴结转移且送检淋巴结数目大于12枚的81例患者的有关资料。其中男51例(62.9%),女30例(37.1%);平均年龄58.7±13.4岁(29～82岁),直肠癌43例(53%),结肠癌38例(47%)。结果 81例患者共计淋巴结1520枚,平均每例患者18.7±6.3枚(12～41枚)。单个转移淋巴结分布情况结果显示肠旁组织淋巴结转移59例(72.8%)。非肠旁组织转移的"跳跃"转移(SM)22例(27.2%)。SM的出现与肿瘤位置、年龄、浸润程度等10项影响因素无明显相关性(P>0.05)。结论大部分结直肠癌SLN转移分布于肠旁,但相当部分可出现"跳跃"现象。SM的出现与肿瘤位置、年龄、浸润程度等临床病理因素无关。

Objective To review the solitary metastatic lymph node distribution and clinical significance in colorectal cancer and to Explore the regular pattern of SLN metastasis and its influent factors in colorectal cancer. Methods The clinical pathological data of 81 patients with colorectal cancer who underwent surgical resection in the First Affiliated Hospital of Guangxi Medical University from September 2008 to November 2009 was confirmed by the routine pathological detection with only one lymph node metastasis and the number of lymph nodes more than 12. The study consisted of 51 men（62.9%） and 30 women（37.1%） whose average age was 58.7 years old （range 29 to 82 years）. And it contained 43 rectal cancer（53% } and 38 colon cancer{47%}. Resnlts A total of 1520 nodes faverage 18. 7＋6.3 per patient; range 12 to 41） were identified in this study group. The Resnlts showed that the single metastatic nodes were found in the nea- rest pericolorectal nodal area in 59 cases （72.8%）. Among 22 eases （27.2%） of coloreetal cancer with ＂ skip＂metastasis. X2 test showed that tumor location, age, depth of bowel wall invasion and so on was not significant correlation with＂skip＂metastasis （ P ~0.05 }. Conclusion The majority SLN of colorectal cancer was distributed in the nearest pericolorectal nodal area, but the rate of ＂skip＂ metastasis is much higher than expected. At the same time the tumor location,age,depth of bowel wall invasion and so on was not related with ＂skipn metastasis.