结直肠癌淋巴结微转移对预后影响的意义  

Prognostic Significance of Lymph No de Micrometastasis in Colorectal Cancer

作　　者：邓昊[1] 舒细记[1] 镇鸿燕[1] 邓羚[1] 陈莹[1] 刘丽江[1] 

机构地区：[1]江汉大学医学与生命科学学院病理学与病理生理学教研室,湖北武汉430056

出　　处：《癌症》2003年第7期762-766,共5页Chinese Journal of Cancer

摘　　要：背景与目的:淋巴结微转移的预后价值尚无一致意见,本研究旨在探讨结直肠癌淋巴结微转移的预后意义。方法:收集江汉大学附属医院1988年～2001年结直肠癌根治性手术切除、有完整淋巴结检查资料的标本80例,其中直肠癌30例,结肠癌50例。经过溶脂法检查淋巴结共3869枚,平均每例48.36枚,经4μm间断连续切片、常规HE染色和免疫组化染色,确定有无淋巴结转移与微转移(微转移灶为瘤团直径<0.2mm或瘤细胞数<50个)。数据经SAS8.1统计学软件进行Cox模型回归分析及Spearman等级相关分析。结果:共检出转移淋巴结232枚(6%),微转移淋巴结39枚(1.01%)。直肠癌中淋巴结转移数与患者生存时间有关(χ2=9.94,P=0.0016);淋巴结微转移与淋巴结转移数(r=0.44,P=0.016)等病理学指标有关。结肠癌中淋巴结转移数(χ2=9.52,P=0.002)、AJCC淋巴结分期(χ2=5.73,P=0.0167)与患者生存时间有关,淋巴结微转移与Dukes’淋巴结分期(r=0.314,P=0.008)有关。结论:淋巴结微转移与结直肠癌预后相关,但不能作为独立的预后指标。BACKGROUND &OBJECTIVE:There have been many controversies about the prog nostic sig nificance of lymph node micromet astasis.The aim of this study was to character ize the prog nostic sig nificance of l ymph node micrometastasis of colorectal cancer.METHODS :Specimens of curative resection between 1988and 2001were collected from The Affiliated Hospi tal of Jiang han University Medical and Lif e Science Colleg e.All 80patients(30cases of rectal cancer,50cases of colon cancer )had complete examination data.A total of 3869lymph nodes (48.36per case)were found by clearing fat method.The interrupted serial 4-micron sec tions,routine hematoxylin and eosi n staining and immunohistochemistry methods w ere used to detect the lymph node metastasis and micrometastasis(small tumor cells cluster diameter ≤0.2mm or tumor cells detected in the lymph n odes ≤50).All data was processed using Cox univariate analysis and Spearma n rank correlation analysis(SAS 8.1software).RESULTS :Metastases were found in 232(6%)lymph nodes examined and micrometastases in 39(1.01%)lymph nodes.In the cases of rectal cancer,a hig hly sig nificant correlation was found between lymph node metastases and mortality by univariate analysis(χ 2 =9.94,P=0.0016)and micrometastases by Spearman rank co rrelation analysis(r=0.44,P=0.016).In the cases of colon cancer,a hig hly sig nificant correlation was found a mong lymph node metastases (χ 2 =9.52,P=0.002),UICC lymph node stag ing(χ 2 =5.73,P=0.0167)and mortality by univariate analysi s.And Spearman rank correlation analysis demonstr ated a sig nificant correlation betw een lymph node micrometastasis and Dukeslym ph node stag ing(r=0.314,P=0.008).CONCLUSION:Lymph node micrometastasis possesses considerable value for prog nosis of colorectal cancer,but should be used in integ ration with ot her indicators.

关 键 词：直肠癌 淋巴结 微转移 预后 结肠癌 

分 类 号：R735.3[医药卫生—肿瘤] R735.37[医药卫生—临床医学]