结直肠癌淋巴结微转移灶的临床病理研究  

Study on the Clinicopathology of Micrometastases in Lymph Nodes of Colorectal Cancer

作　　者：康安定[1,2] 邓亚平 高妮娜[1,3] 谭平萍 刘志红[1,3] 

机构地区：[1]湖南省肿瘤医院 [2]中南大学湘雅医学院附属肿瘤医院肠道外科,湖南长沙410013 [3]中南大学湘雅医学院附属肿瘤医院病理科,湖南长沙410013

出　　处：《现代生物医学进展》2013年第24期4698-4701,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨结直肠癌淋巴结微转移灶的特点及其临床病理意义。方法:对我院2001年1月-2006年10月收治的56例无组织学淋巴结转移的结直肠癌患者的650个淋巴结进行微转移灶的免疫组织化学和组织学检测,并分析微转移灶与患者临床病理特征之间的关系。结果:通过对4μm厚淋巴结连续切片进行观察,连续切片五片的微转移灶检出率较一片和两片的的微转移灶检出率显著升高(P<0.05)。按解剖部位分组的患者微转移灶阳性率1组有66.67%(16/24),2组有60%(9/15),3组有41.2%(7/17),无显著性差别(P>0.05)。微转移灶与无组织学淋巴结转移的结直肠癌患者的肿瘤浸润深度(P=0.013)和肿块大小(P=0.037)存在显著性相关,但有微转移灶和无微转移灶的无组织学淋巴结转移的结直肠癌患者总体生存状况比较无显著差异(P>0.05)。结论:微转移灶在无组织学淋巴结转移的结直肠癌淋巴结中较常见,与肿瘤大小和浸润深度有关,但与患者的预后无显著相关性。Objective： To investigate the feature and clinicopathological significance of lymph node micrometastases in colorectal cancer （CRC）. Methods： 56 colorectal cancer patients without histologically lymph node metastasis in our hospital from January 2001 to October 2006 were selected, and 650 lymph nodes from these cases were assayed by immunohistochemical method and histomorphologically for micrometastases detection, and the relationship of micrometastasis to clinicopathological characteristics were analysized. Results： The positive frequency of micrometastasis was significantly higher through observation of the 4-p^m-thick lymph node sections by five slices than by one or two slices （P〈0.05）. According to the anatomic site, positive rate of micrometastasis was 66.67% （16/24） in groupl, 60% （9/15） in group 2, 41.2%（7/17） in groups3, no significant difference （P〉0.05）. presence of micrometasta- sis in lymph nodes of CRC was significantly associated with depth of invasion （P=0.013） and tumor size （P=0.037）, and there was no significant relationship of micrometastasis in node-negative CRC patients to survival. Conclusion： The micrometastases are common in lymph node without histologically lymph node metastasis, and were associated with the tumor size and the depth of invasion, but no significant correlation with the prognosis of the patients.

关 键 词：微转移灶 结直肠癌 预后 淋巴结转移 

分 类 号：R602[医药卫生—外科学] R735.3[医药卫生—临床医学]