直肠癌淋巴结转移的临床规律探析  

Rules of lymphatic metastasis of rectal carcinoma

作　　者：杨涵[1] 潘贻飞[1] 高尔立[1] 张筱骅[1] 

机构地区：[1]温州医学院附属第一医院肿瘤外科,325000

出　　处：《中国综合临床》2013年第7期673-675,共3页Clinical Medicine of China

基　　金：温州市科技计划项目（Y20090008）

摘　　要：目的探讨直肠癌淋巴结转移的临床规律，为直肠癌的临床诊治提供参考。方法对我院2006年11月至2012年1月收治的222例行手术治疗的直肠癌患者资料进行分类整理，对各因素与淋巴结转移的相关性进行归纳分析，并进行Logistic回归分析。结果（1）性别与淋巴结转移率没有明显的相关性（x^2=0．000，P〉0．05）。（2）淋巴结的转移率随着年龄的增大而降低且差异有统计学意义（X^2=5．001，P〈0．05）。（3）肿瘤所在部位与淋巴结转移率差异无统计学意义（X^2=0．052，P〉0．05），但有直肠癌距肛门越近淋巴结转移率越高的趋势，其大小与淋巴结转移率具有明显的相关性，2．5～5．5cm组和≥5．5cm组淋巴结转移率明显高于≤2．5cm组且差异有统计学意义（x。=2．267，P〈0．05）。（4）肿瘤侵犯肠管周径与淋巴结转移率密切相关（x^2=2．323，P〈0．05）。（5）淋巴结的转移率与浸润深度有密切关系，转移率随着浸润深度的增加而升高（x^2=2．277，P〈0．05）。（6）随着肿瘤分化程度的降低淋巴结的转移率显著升高（x^2=4．322，P〈0．01）。（7）Logistic回归分析表明，肿瘤分化程度、浸润程度及侵犯肠管周径对淋巴结转移有影响，OR（95％CI）分别为5．562（0．105—0．444）、2．178（0．144—0．971）、1．563（0．038～8．613）（P均〈0．01）。结论直肠癌淋巴结转移与患者的年龄、肿瘤的大小、侵犯肠管的周径、浸润的深度以及分化的程度具有密切的相关性，其中肿瘤的分化程度对淋巴结转移的影响最为显著。Objective To investigate the regulations of lymphatic metastasis of rectal carcinoma which can provide help of clinical diagnosis and treatments. Methods A retrospective analysis was performed of 222 patients with rectal carcinoma who underwent surgical resection from November 2006 to January 2012. Summarize the relevance of each factor and lymph node metastasis by logistic regression analysis. Results （ 1 ） Gender and lymph node metastasis has no significant correlation （ X2 = 0. 000, P 〉 0. 05 ）. （2） Lymph node metastasis rate reduced with increasing age and the difference was statistically significant （ X2 = 5.001, P 〈 0. 05 ）. （3） There is no significant difference between tumor location and lymph node metastasis rate （X2 =0. 052 ,P 〉 0. 05 ） ,when the distance between anal rectal cancer and the anus was closer, the tendency of lymph node metastasis was higher, and there has the obvious correlation with lymph node metastasis rate of its size,2. 5 to 5.5 cm group and more than 5.5 cm lymph node metastasis rate was significantly higher than less than 2. 5 cm group with a significant difference （X2 = 2. 267, P 〈 0.05 ）. （4） Tumor invasion of the intestinal circumference was closely related with lymph node metastasis rate （X2 = 2. 323, P 〈 0. 01 ）. （ 5 ） Lymph node metastasis rate was closely related to the depth of invasion, metastasis rate increased with the depth of invasion increasing （ X2 = 2. 277, P 〈 0. 05）. （6） Lymph node metastasis was significantly higher with the decrease of the degree of tumor differentiation （ X2 = 4. 322, P 〈 0. 01 ） . Logistic regression analysis showed that the degree of tumor differentiation, infihration and invasion of intestinal circumference diameter lymph node metastasis influential, OR （95% CI） was 5. 562 （0. 105 -0. 444） ,2. 178 （0. 144 -0. 971 ）, 1. 563 （0. 038 -8. 613） respectively （P 〈 0.01 ）. Conclusion The lymphatic metastasis of rectal carcinoma is related to age, tumor size, intes

关 键 词：直肠癌 淋巴结转移 临床规律 探析 

分 类 号：R735[医药卫生—肿瘤]