右半结肠癌患者回肠周围淋巴结转移特点的临床分析  

Clinical analysis of metastatic characteristics of lymph node metastasis around the ileum in patients with right colon cancer

作　　者：林达佳[1] 吴健生[1] 曾长青[1] 陈林昊[1] 黄海啸[1] LIN Dajia;WU Jiansheng;ZENG Changqing;CHEN Linhao;HUANG Haixiao(Department of Gastroenterology,Provincial Clinic College of Fujian Medical University,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院福建省立医院胃肠外科

出　　处：《中国现代医生》2019年第21期55-58,共4页China Modern Doctor

摘　　要：目的探讨右半结肠癌患者回肠周围淋巴结的转移特点及相关危险因素。方法回顾性分析2012年1月~2018年6月我院收治的259例右半结肠癌患者的临床病理资料,对回肠周围淋巴结转移的相关危险因素进行统计学分析。结果本研究中总淋巴结转移率为44.0%(114/259),而回肠周围淋巴结总体转移率仅为5.0%,其中盲肠部位肿瘤的回肠周围淋巴结转移率为14.3%。单因素分析显示回肠周围淋巴结转移状态在肿瘤位置(P<0.001)、肿瘤分化程度(P=0.013)、TNM分期(P<0.001)、N分期(P<0.001)、脉管侵犯情况(P=0.001)等因素的差异有统计学意义。Logistic回归分析显示盲肠部位的肿瘤其回肠周围淋巴结转移风险是其他部位肿瘤的6.97倍(P=0.001,95%CI:2.246~21.626),且N分期为回肠周围淋巴结转移的独立危险因素。结论回肠周围淋巴结在右半结肠癌中转移率较低,与其他部位的右半结肠癌相比,盲肠癌有较高的回肠周围淋巴结转移率;高N分期的右半结肠癌患者有较高的回肠周围淋巴结转移率。Objective To investigate the metastasis characteristics and related risk factors of lymph nodes around the ileum in patients with right colon cancer.Methods The clinical and pathological data of 259 patients with right colon cancer admitted to our hospital from January 2012 to June 2018 were retrospectively analyzed,and statistical analysis of risk factors related to lymph node metastasis around the ileum was performed.Results The total lymph node metastasis rate was 44.0%(114/259) in this study,while the overall metastatic rate of lymph node around the ileum was only 5.0%.The lymph node metastasis rate around the ileum in the cecal site tumor was 14.3%.Univariate analysis showed that there was significant difference in tumor location(P<0.001),tumor differentiation(P=0.013),TNM stage(P<0.001),N stage(P<0.001),and vascular invasion(P=0.001) of lymph node metastasis around the ileum.Logistic regression analysis showed that the risk of lymph node metastasis around the ileum was 6.97 times higher than that of other sites(P=0.001,95%CI: 2.246-21.626).N staging was an independent risk factor for lymph node metastasis around the iluem.Conclusion The rate of lymph node metastasis around the ileum is lower than that of right colon cancer.Compared with other right colon cancers,cecal cancer has a higher rate of lymph node metastasis around the ileum.Patients with high N stage right colon cancer have a higher rate of lymph node metastasis around the iluem.

关 键 词：右半结肠癌 回肠周围淋巴结 转移特点 危险因素 

分 类 号：R735.35[医药卫生—肿瘤]