结肠肿瘤_____结肠肿瘤;淋巴结;转移;预后

结肠癌淋巴结转移状况对结肠癌根治术D3式淋巴结清除预后的影响

http://www.100md.com 《结直肠肛门外科杂志》 2006年第2期

结肠肿瘤,,结肠肿瘤;淋巴结;转移;预后,1资料和方法,2结果,3讨论,参考文献

     摘要目的：探索结肠癌淋巴结转移情况与术后生存率以及病理参数之间的关系，寻找评价预后的简单有效指标。方法：回顾性分析了174例淋巴结转移的中晚期结肠癌住院资料和随访结果，调查了根治术D3式淋巴结清除术的阳性淋巴结率以及淋巴结转移阳性个数，以及术后生存率和病理参数特点。结果：结肠癌根治术+D3式淋巴结清除术后总体5年生存率为356%(62/174)。阳性淋巴结率在1%～20%的5年生存率707%(29/41),大于20%的5年生存率为233%(31/133)，两者之间存在显著性差异(P<005)。全组淋巴结转移阳性个数为(63±25)个，1～5个阳性淋巴结的5年生存率为660%(31/47)，6～10个阳性淋巴结的5年生存率为288%(19/66)，大于10个阳性淋巴结的5年生存率为197%(12/61)，3组之间存在显著性差异(P<005)。阳性淋巴结率以及淋巴结转移阳性个数与肿瘤部位无关。和瘤体直径介于0～40 cm相比较，>40 cm肿瘤的阳性淋巴结率以及淋巴结转移阳性个数明显增加(P<005)。和局限于黏膜的肿瘤相比，浸润肌层或穿透浆膜后，阳性淋巴结率以及淋巴结转移阳性个数明显增加(P<005)，而肿瘤浸润肌层和穿透浆膜之间不存在差异。结论：准确计算阳性淋巴结率及淋巴结转移阳性个数,结合肿瘤浸润深度来评定结肠癌病人的预后是一种简单有效的方法。

    关键词结肠肿瘤;淋巴结;转移;预后

    The Relationship between Lymph Nodes Metastasis and Prognosis of Colon Carcinoma after Radical Operation

    Zhang Caiyun, Song Yue, Zhang Yaoming.

    Department of General Surgery, Meizhou Hospital, Meizhou City, Guangdong Province 514031

    Abstract Objective:To explore the relationship among lymph nodes metastasis, the survival rate after radical operation and pathological parameter in order to find a simple and effective method to evaluate the prognosis of colon carcinoma. Methods:Clinical and followup data of 174 patients with colon carcinoma in intermediateadvanced stage were analyzed retrospectively.Results:The 5year survival rate was 35.6% (62/174) after radical operation plus D3 lymph node dissection. There was significant difference(P<0.05) in fiveyear survival rate between patients with 1～20% lymph nodes involved and patients with > 20% lymph nodes involved(70.7%(29/41) VS. 23.3%(31/133)). The average number of involved lymph nodes was 6.3±2.5. The fiveyear survival rates were 66.0%(31/47), 28.8%(19/66), 19.7%(12/61), respectively, in patients with 1～5, 5～10, and > 10 involved lymph nodes(P<0.05). There was no relationship between the location of tumors and the status of lymph nodes. More involved lymph nodes were found in tumor with diameter > 4.0cm, compared with tumor with diameter 0～4.0cm. After invasion of muscular layer of colon, the ratio and number of involved lymph node increased significantly. But the involved lymph nodes were similar in tumors infiltrated muscular layer or serosa. Conclusion:Combining the infiltrating depth, the ratio and number of involved lymph nodes is a simple and effective method to evaluate the prognosis of colon carcinoma after radical operation. ......

百拇医药网 http://www.100md.com/html/DirDu/2006/06/10/00/78/60.htm

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