AIM To detect the existence of isolated cancer cells in the mesentery of colorectum(named as Metastasis V), and investigate its clinical significance in colorectal cancer(CRC) patients.METHODS Sixty-three CRC patients...AIM To detect the existence of isolated cancer cells in the mesentery of colorectum(named as Metastasis V), and investigate its clinical significance in colorectal cancer(CRC) patients.METHODS Sixty-three CRC patients who received radical excision between January 2012 and September 2015 were included. All the patients underwent laparoscopyassisted radical colorectomy or proctectomy [with complete mesocolic excision(CME) or total mesorectal excision(TME)] with R0 dissections at the Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. The location and size of the primary lesions were recorded immediately after the tumor was removed, with the surrounding mesenterium completely separated along the intestinal wall. Each dissected mesentery sample was analyzed for hematoxylin-eosin staining and immunohistochemistry using cytokeratin 19 antibody. Image Pro Plus Software 6.0(Media Cybernetics, CA, United States) was usedto semi-quantitatively measure the concentration of the cytokeratin 19 immunohistochemistry. The correlation between metastasis found in mesentery and clinicopathological characteristics was examined. The prognosis of patients was also evaluated by preoperative serum CEA level.RESULTS Metastasis V was detected in 14 of 63(22.2%) CRC patients who underwent laparoscopy-assisted radical colorectomy or proctectomy(with CME or TME) with R0 dissection in our hospital between January 2012 and September 2015. There was no significant difference in age, gender, tumor size, and tumor location in patients with Metastasis V(P > 0.05). Metastasis V was more likely to occur in poorly differentiated tumor(5/11; 45.5%) than moderately(8/46; 17.4%) and welldifferentiated one(1/6; 16.7%). The Metastasis V in N2 stage(9/14; 64.3%) was more frequent that in the N0 stage(3/35; 8.6%) or N1 stages(2/14; 14.3%). In addition, Metastasis V was positively related to the tumor invasive depth(T1:0/1, 0%; T2:1/12, 8.3%; T3:7/39, 17.9%; T4:6/11, 54.5%). Furthermore, preoperative serum CEA level in Metastasis V-positive patients was significantly higher than in Metastasis V-negative patients(4.27 ng/m L vs 3.00 ng/m L).CONCLUSION Metastasis V might be associated with a poor prognosis of CRC patients.展开更多
AIM: To study the distribution of positive lymph nodes within mesorectum and to investigate the possible micrometastasis in negative lymph nodes. METHODS: Large slice technique combined with tissue microarray was used...AIM: To study the distribution of positive lymph nodes within mesorectum and to investigate the possible micrometastasis in negative lymph nodes. METHODS: Large slice technique combined with tissue microarray was used in the pathologic study of 31 specimens.RESULTS: A total of 992 lymph nodes were harvested and cancer metastasis was found in 148 lymph nodes. Some positive lymph nodes were located in the outer layer of mesorectum and more at the same site of mesorectum as the primary tumor. Circumferential margin lymph node metastasis was observed in nine cases. No significant difference in occurrence of micrometastasis was observed in different stage tumors. CONCLUSION: Positive lymph nodes are distributed in mesorectum and micrometastasis can be found in negative lymph nodes.展开更多
Objective:The aim of our study was to investigate the lymph node metastasis of mesorectum and ischiorectal foss in ultra-low rectal cancer and its influence on the surgical procedure selection.Methods:Large slices and...Objective:The aim of our study was to investigate the lymph node metastasis of mesorectum and ischiorectal foss in ultra-low rectal cancer and its influence on the surgical procedure selection.Methods:Large slices and tissue microarray technology were used to detect metastasis lymph nodes from 23 dissected specimens of ultra-low rectal cancer.Results:415 lymph nodes were detected in the 23 specimens.169 and 59 lymph nodes were metastasis and micrometastasis, respectively.Twelve specimens were diagnosed with lymph node metastasis, while other 4 specimens were with lymph node micro-metastasis.There were 29.0% (49/169) and 17.2% (29/169) metastatic lymph nodes located in the outer and anterior region of mesorectum.There were 2 cases with ischiorectal fossa lymph node metastasis and 1 case with micrometastasis.The 3 metastatic cases were only 13% (13/23) of all the 23 cases.Conclusion:There is regional lymph node metastasis existing in ultra-low rectal cancer.The metastatic incidences in distal mesorectum and ischiorectal fossa are relatively low.Considering Miles operation as the standard surgical procedure for ultra-low rectal cancer should be evaluated renewedly.展开更多
基金Supported by the National Natural Science Foundation of China,No.81572861,No.81302309 and No.81372324
文摘AIM To detect the existence of isolated cancer cells in the mesentery of colorectum(named as Metastasis V), and investigate its clinical significance in colorectal cancer(CRC) patients.METHODS Sixty-three CRC patients who received radical excision between January 2012 and September 2015 were included. All the patients underwent laparoscopyassisted radical colorectomy or proctectomy [with complete mesocolic excision(CME) or total mesorectal excision(TME)] with R0 dissections at the Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. The location and size of the primary lesions were recorded immediately after the tumor was removed, with the surrounding mesenterium completely separated along the intestinal wall. Each dissected mesentery sample was analyzed for hematoxylin-eosin staining and immunohistochemistry using cytokeratin 19 antibody. Image Pro Plus Software 6.0(Media Cybernetics, CA, United States) was usedto semi-quantitatively measure the concentration of the cytokeratin 19 immunohistochemistry. The correlation between metastasis found in mesentery and clinicopathological characteristics was examined. The prognosis of patients was also evaluated by preoperative serum CEA level.RESULTS Metastasis V was detected in 14 of 63(22.2%) CRC patients who underwent laparoscopy-assisted radical colorectomy or proctectomy(with CME or TME) with R0 dissection in our hospital between January 2012 and September 2015. There was no significant difference in age, gender, tumor size, and tumor location in patients with Metastasis V(P > 0.05). Metastasis V was more likely to occur in poorly differentiated tumor(5/11; 45.5%) than moderately(8/46; 17.4%) and welldifferentiated one(1/6; 16.7%). The Metastasis V in N2 stage(9/14; 64.3%) was more frequent that in the N0 stage(3/35; 8.6%) or N1 stages(2/14; 14.3%). In addition, Metastasis V was positively related to the tumor invasive depth(T1:0/1, 0%; T2:1/12, 8.3%; T3:7/39, 17.9%; T4:6/11, 54.5%). Furthermore, preoperative serum CEA level in Metastasis V-positive patients was significantly higher than in Metastasis V-negative patients(4.27 ng/m L vs 3.00 ng/m L).CONCLUSION Metastasis V might be associated with a poor prognosis of CRC patients.
基金Supported by the Grants From the Key Project of National Outstanding Youth Foundation of China,No.39925032
文摘AIM: To study the distribution of positive lymph nodes within mesorectum and to investigate the possible micrometastasis in negative lymph nodes. METHODS: Large slice technique combined with tissue microarray was used in the pathologic study of 31 specimens.RESULTS: A total of 992 lymph nodes were harvested and cancer metastasis was found in 148 lymph nodes. Some positive lymph nodes were located in the outer layer of mesorectum and more at the same site of mesorectum as the primary tumor. Circumferential margin lymph node metastasis was observed in nine cases. No significant difference in occurrence of micrometastasis was observed in different stage tumors. CONCLUSION: Positive lymph nodes are distributed in mesorectum and micrometastasis can be found in negative lymph nodes.
文摘Objective:The aim of our study was to investigate the lymph node metastasis of mesorectum and ischiorectal foss in ultra-low rectal cancer and its influence on the surgical procedure selection.Methods:Large slices and tissue microarray technology were used to detect metastasis lymph nodes from 23 dissected specimens of ultra-low rectal cancer.Results:415 lymph nodes were detected in the 23 specimens.169 and 59 lymph nodes were metastasis and micrometastasis, respectively.Twelve specimens were diagnosed with lymph node metastasis, while other 4 specimens were with lymph node micro-metastasis.There were 29.0% (49/169) and 17.2% (29/169) metastatic lymph nodes located in the outer and anterior region of mesorectum.There were 2 cases with ischiorectal fossa lymph node metastasis and 1 case with micrometastasis.The 3 metastatic cases were only 13% (13/23) of all the 23 cases.Conclusion:There is regional lymph node metastasis existing in ultra-low rectal cancer.The metastatic incidences in distal mesorectum and ischiorectal fossa are relatively low.Considering Miles operation as the standard surgical procedure for ultra-low rectal cancer should be evaluated renewedly.
