直肠癌肠系膜下动脉根部淋巴结微小转移的临床意义  

Clinical Significance of Lymph Node Micrometastasis around the Root of Inferior Mesenteric Artery in Rectal Carcinoma

作　　者：董大海[1] 李静慧[1] 赵雪峰[1] 

机构地区：[1]大连大学附属新华医院肛肠外科,辽宁大连116021

出　　处：《医学与哲学（B）》2015年第6期42-44,共3页Medicine & Philosophy(B)

摘　　要：研究直肠癌肠系膜下动脉(IMA)根部淋巴结微小转移在全直肠系膜切除加1级、2级和3级淋巴结(D3淋巴结)清扫术中的意义。将48例直肠癌D3淋巴结清扫患者的141枚IMA根部淋巴结,进行HE染色和免疫组化染色研究。常规HE染色结果,8例(32/141)患者的IMA根部淋巴结为转移阳性。常规HE染色阳性组与肿瘤位置和组织病理学有相关性,其差异有统计学意义(P<0.05)。免疫组化染色结果,13例(38/109)患者的IMA根部淋巴结为微小转移阳性。免疫组化阳性组与肿瘤位置、组织病理学及肿瘤浸润深度有相关性,其差异有统计学意义(P<0.05)。免疫组化组IMA根部淋巴结转移率明显高于常规HE染色组(P<0.001)。直肠癌IMA根部淋巴结微小转移发生率高,直肠癌转移初期IMA根部淋巴结有微小转移,清扫IMA根部淋巴结对直肠癌D3淋巴结清扫有效。To investigate factors affecting the lymph node micrometastasis around the root of inferior mesenteric artery （IMA） in total mesorectum excision with D3 lymph node dissection .A total of 141 lymph nodes of the IMA root ,obtained from 48 patients with D3 lymph node dissection of rectal carcinoma were evaluated using HE staining and immunohistochemistry .Lymph node metastasis around the root of IMA was found in 32 of 141 nodes of 8 patients by routine HE staining . The HE staining positive group had a significantly low tumor location and poorly histological classification （P〈0 .05） .Lymph node micrometastasis the root of IMA was immunohistochemically detected in 38 of 109 negative nodes from 13 of 40 patients .The immunohistochemistry positive group had a significantly low tumor location , poorly histological classification ,and higher deep of invasion （P〈0 .05） .The lymph node metastasis rate of IMA root was higher by immunohistochemistry group than by HE staining group （P〈 0 .001） .We have high rate of Lymph node metastasis around the root of IMA with rectal carcinoma ,and have confirmed that IMA root of D3 lymph node dissection is effective for radical surgery patients . Lymph node micrometastasis around the root of IM A is observed in the early metastasis stage of rectal carcinoma .

关 键 词：直肠癌 肠系膜下动脉根部 淋巴结微小转移 

分 类 号：R615[医药卫生—外科学] R735.37[医药卫生—临床医学]