直肠癌淋巴结转移与临床病理特征分析(附79例报道)  

Analysis of Lymph Node Metastasis and Clinical Characteristic in Rectal Cancer(Report of 79 Cases)

作　　者：李德福[1] 张敏[1] 

机构地区：[1]四川省眉山市第二人民医院普外科,眉山620010

出　　处：《中国普外基础与临床杂志》2008年第9期652-655,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨直肠癌淋巴结转移与临床病理特征及术后生存率之间的关系。方法分析79例行全直肠系膜切除术患者的性别、年龄、肿瘤原发灶大小、大体类型、浸润深度、组织学类型、分化程度及术前血清癌胚抗原(CEA)水平与术后淋巴结病检转移情况及生存率的关系。结果单因素分析结果发现,肿瘤大小、大体类型、浸润深度、组织学类型、分化程度及血清CEA水平与淋巴结转移有关;进一步多因素分析结果提示,肿瘤大体类型和浸润深度与淋巴结转移有关。无淋巴结转移组生存率高于有淋巴结转移组(χ2=18.806,P=0.000);淋巴结转移数<4个组生存率高于淋巴结转移数≥4个组(χ2=4.659,P=0.031)。结论直肠癌患者的临床病理特征在一定程度上反映淋巴结转移情况,了解其间关系有利于对直肠癌淋巴结转移情况的评估和预后的判断。Objective To investigate the correlation among lymph node metastasis and clinical features, postoperative survival rate in rectal cancer. Methods Seventy nine patients who had accepted total mesorectal excision （TME） were collected, and the correlation among their clinical features （including gender, age, tumor size, gross type, depth of infiltration, histology type, differentiated degree and the level of blood serum CEA）, lymph node metastasis, and postoperative survival rate were analyzed. Results There was significant correlation between six factors （namely the tumor size, gross type, depth of infiltration, histology type, differentiated degree and the level of blood serum CEA） and lymph node metastasis in single factor analysis. However, multivariate analysis showed that only gross type of tumor and depth of tumor infiltration were related to lymph node metastasis. The postopera tive survival time of 43 non metastasis cases was remarkably longer than that of 33 cases with lymph node metastasis （X^2=18. 806, P=-0. 000）, and it was longer in 22 cases with 〈4 lymph nodes metastasis than that of 11 cases with ≥4 lymph nodes metastasis （X^2 =4. 659, P=0. 031）. Conclusion In rectal cancer patients the clinical features can reflect the condition of lymph node metastasis in a certain extent, and it can help doctors to evaluate the lymph node metastasis and prognosis.

关 键 词：直肠癌 淋巴结转移 临床病理 

分 类 号：R735.37[医药卫生—肿瘤]