结直肠癌淋巴结转移多因素分析

目的　探讨结直肠癌淋巴结转移的相关因素。方法　收集南方医院 1975～ 1999年间手术治疗的结直肠癌 1374例 ,建立全部资料的Access数据库 ,选择相关的字段进行检索 ,从不同角度分析各临床及病理因素与淋巴结转移的关系。结果　 30岁以下年龄组的淋巴结转移率为 5 1 9% ,5 1岁以上年龄组的淋巴结转移率为 31 3%。随着肿瘤浸润深度的增加 ,其淋巴结转移率增高。随肠管受肿瘤侵犯的周径增大 ,淋巴结转移可能性增大。隆起型肿瘤的淋巴结转移率为 30 9% ,溃疡型为 39 7% ,浸润型为 42 1% ,胶样型为 42 9%。腺癌、黏液腺癌、印戒细胞癌的转移率分别为 33 3%、49 6 %和 6 1 1% ,且随肿瘤的分化程度降低 ,淋巴结转移率增高。肿瘤体积的大小及术前癌胚抗原 (CEA)水平与淋巴结转移无关。结论　结直肠癌的淋巴结转移与多种因素有关 ,这些因素主要有 :年龄、肿物侵犯肠管周径、大体类型、病理类型、分化程度、生长方式、浸润深度。肿物体积的大小与淋巴结转移无关。这些因素之间是互相联系、互相影响的。

Correlation analysis of factors related with lymph node metastasis in colorectal cancer

Objective To investigate the factors related with the lymph node metastasis (LNM) in colorectal cancer. Methods 1 374 patients with colorectal carcinoma undergone surgery from 1975 to 1999 in Nanfang Hospital were analyzed, and Access database was build up to find out the factors concerned. Results The lymph node metastasis rates of age <30 and >50 were 51 3% and 31 3% respectively. The rate of LNM rose with the increase of depth and circumference of penetration. The rates of LNM in protruded type, ulcerative type, infiltrating type and colloid type were 30 9%, 39 7%,42 1%,42 9%,respectively. The rates of LNM in adenocarcinoma, mucoid carcinoma, signet ring cell carcinoma were 33 3%, 49 6%, 61 1%. LNM occurred significantly less in well differentiated cancers than that in bad differentiated. Tumor size and serum CEA level before operation were not significantly predictive factors for LNM. Conclusions The main factors related with LNM in colorectal carcinoma are age, circumference and depth of penetration, gross type, pathological type, differentiated degree, and growth type. Tumor size and serum CEA level before operation are not related to LNM.