直肠癌淋巴结跳跃转移临床病理分析  

Clinical pathological analysis of rectal cancer lymph node skips metastasis

作　　者：杜晓辉[1] 宁宁[1] 赵允杉[1] 

机构地区：[1]解放军总医院普通外科,北京100853

出　　处：《中华外科杂志》2012年第3期219-221,共3页Chinese Journal of Surgery

基　　金：国家自然科学基金资助项目（60601018、61170123）;军队十一五科技攻关课题资助项目（06G107）

摘　　要：目的通过对直肠癌淋巴结跳跃转移的临床病理特点进行分析探讨直肠癌根治术高位血管结扎的意义。方法回顾性分析2009年10月至2010年10月行根治性直肠癌切除的207例患者资料，观察肠系膜下动脉周围及其根部淋巴结发生跳跃转移的情况，分析临床病理因素与跳跃转移间的相关性。结果207例直肠癌患者手术切除标本中共检出淋巴结2305枚，有转移的患者168例。跳跃转移与肿瘤的分化程度（X^2=113．65，P=0．037）及肿瘤浸润深度（X^2=108．22，P=0．042）相关，与性别、年龄、部位、大小、术前血清癌胚抗原水平、大体类型和组织类型因素均无明显相关性。结论术前对直肠癌肿瘤分化程度及浸润深度进行评估，有助于提示是否存在淋巴结跳跃转移；对于有跳跃转移风险的患者应行血管高位结扎淋巴结清扫术。Objective To analyze clinical and pathological of lymph node skip metastasis of rectal cancer and discuss the meaning of the high vascular ligation. Methods A retrospective analysis of 207 cases for radical resection of rectal cancer was made, meanwhile the skip metastasis of the roots of the inferior mesenterie artery lymph nodes was studied. Combined with clinical data, the relevance of clinical and pathological factors with the skip metastasis was analyzed. Results The 207 cases of rectal cancer patients surgical resection specimen detected 2305 pieces of lymph node, the transfer of 168 patients with. The statistical analysis found that skip metastasis related with tumor differentiation （X^2 = 113.65, P = 0.037） and depth of tumor invasion （X^2 = 108.22, P = 0.042） , but gender, age, location, size, preoperative carcinoembryonic antigen level, gross type and tissue types factors were not significantly correlation. Conclusions Preoperative differentiation of cancer and tumor invasion depth assessment can help prompt the existence of lymph node skip metastasis. The assessment of the risk of skip metastasis for patients should be performed the high vascular ligation and lymph node dissection.

关 键 词：直肠肿瘤 淋巴转移 结直肠外科手术 淋巴结切除术 

分 类 号：R735.37[医药卫生—肿瘤]