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目的 探讨大肠癌淋巴结转移相关的病理学因素。方法 对 3 68例大肠癌切除标本按统一标准 ,进行组织学分类、浸润深度、癌周淋巴细胞反应等项检查 ,探讨其与淋巴结内癌转移的关系。结果 淋巴结内癌转移率为 3 3 4% ,其中肠旁组淋巴结转移率占 77 2 % ,肠系膜淋巴结及系膜动脉结扎处淋巴结转移率占 17 9%和 4 9%。癌肿长径 >6cm及浸润深度达浆膜外 ,癌周淋巴细胞反应强度 >+++时癌转移率最高 (P <0 0 0 5 ) ,组织学分级级别越高 ,癌转移率越高。组织类型与癌转移率有明显相关性 (P <0 0 5 ) ;结论 大肠癌淋巴结内癌转移以肠旁组为主 ,常为逐站转移 ,转移率与肿瘤大小、浸润深度呈正相关 ,与分化程度及淋巴细胞反应强度呈负相关 ,与组织学类型有明显相关性。
Objective To investigate the pathological factors associated with lymph node metastasis in colorectal cancer. Methods A total of 368 colorectal cancer resected specimens were examined by histological classification, depth of invasion and peritumoral lymphocytic reaction according to a uniform standard to explore the relationship between them and lymph node metastasis. Results The rate of lymph node metastasis in lymph nodes was 33.4%. The rate of lymph node metastasis in intestinal metaplasia group was 77.2%. The rate of lymph node metastasis in mesenteric lymph node and mesangial artery was 17.9% and 49% respectively. The cancer metastasis rate was the highest (> 0.05%) when the diameter of cancer was> 6 cm and the depth of invasion was beyond the serosa. The higher the degree of histological grading, the higher the rate of cancer metastasis . There was a significant correlation between the type of tumor and the rate of metastasis (P <0.05). Conclusion The metastasis of lymph node in colorectal cancer is mainly intestinal metaplasia, which is often by station. The metastasis rate is positively correlated with tumor size and depth of invasion. The degree of differentiation and the intensity of lymphocyte reaction were negatively correlated with the histological type of significant correlation.