一种改良淋巴结检出方法在结直肠癌术后病理检查中的应用

Application of an improved lymph node detection method in postoperative pathological examination of colorectal cancer

目的探讨一种改良淋巴结检出方法在结直肠癌术后病理检查中的应用。方法采用改良的淋巴结检出方法——强光直视下顺血管分层检出法对2016年11月~2019年2月在佛山市第一人民医院肛肠外科接受结直肠癌根治手术的100例手术标本进行淋巴结检出。结果 100例结直肠癌手术标本通过改良方法共检出淋巴结2303枚,平均每例(23.03±10.94)枚;阳性淋巴结178枚,平均每例(1.78±2.99)枚;53例直肠癌共检出淋巴结1138枚,平均每例(21.47±8.37)枚;阳性淋巴结91枚,平均每例(1.72±2.82)枚;23例乙状结肠癌共检出淋巴结442枚,平均每例(19.22±7.67)枚;阳性淋巴结43枚,平均每例(1.87±2.60)枚;8例降结肠癌共检出淋巴结130枚,平均每例(16.25±5.44)枚;阳性淋巴结13枚,平均每例(1.63±1.77)枚;16例右半结肠癌共检出淋巴结593枚,平均每例(37.06±13.19)枚;阳性淋巴结31枚,平均每例(1.94±4.42)枚;共7例结直肠癌标本术后淋巴结检出数不足12枚,分别为2例降结肠癌检出淋巴结(0/8)枚、(4/10)枚;3例乙状结肠癌检出淋巴结为(1/8)枚、(1/9)枚、(0/10)枚;2例直肠癌检出淋巴结为(0/6)枚、(1/11)枚。结论改良淋巴结检出方法——强光直视下顺血管分层检出法是一种可行的淋巴结检出方法,具有在技术操作简单、无额外费用、易于推广等优点,能满足病理分期要求。

Objective To investigate the effect of an improved lymph node detection method in pathological examination of colorectal cancer after operation. Methods A modified method of lymph node detection was used to detect lymph nodes in 100 patients undergoing radical operation for colorectal cancer from November 2016 to February 2019 in the Anorectal Surgery Department of First People′s Hospital of Foshan. Results A total of 2303 lymph nodes were detected in 100 colorectal cancer surgical specimens by modified method,with an average of(23.03±10.94)lymph nodes per case,178 positive lymph nodes(1.78±2.99)per case,1138 lymph nodes(21.47±8.37)per case,91 positive lymph nodes(1.72±2.82)per case,and 23 sigmoid colorectal cancer. There were 442 nodules with an average of(19.22±7.67)in each case;43 positive lymph nodes with an average of(1.87±2.60)in each case;130 lymph nodes with an average of(16.25±5.44)in 8 cases of descending colon cancer;13 positive lymph nodes with an average of(1.63±1.77)in each case;593 lymph nodes were detected in 16 cases of right colon cancer,with an average of(37.06±13.19)in each case;and 31 positive lymph nodes with an average of(37.06±13.19)in each case. Each case(1.94±4.42). There were less than 12 lymph nodes detected in 7 cases of colorectal cancer after operation,which were 0/8 and 4/10 lymph nodes detected in 2 cases of descending colon cancer,1/8,1/9 and 0/10 lymph nodes detected in 3 cases of sigmoid colon cancer,and 0/6 and 1/11 lymph nodes detected in 2 cases of rectal cancer. Conclusion The improved lymph node detection method,the high light direct vision method,was a feasible method for lymph node detection. It has the advantages of simple operation,no additional cost and easy popularization. It could meet the requirements of pathological staging.