T2期直肠癌淋巴结转移相关影响因素

目的探讨影响T2期直肠癌淋巴结转移的临床病理因素。方法回顾分析福建医科大学附属第一医院2006年3月至2011年1月间行根治性切除的122例T2期直肠癌患者的临床资料,分析影响其淋巴结转移的相关临床病理因素。结果122例T2期直肠癌患者中有26例（21．3％）发生淋巴结转移。单因素分析显示,肿瘤距肛缘距离（P〈0.05）、大体类型（P〈0.05）、组织类型（P〈0．01）、分化程度（P〈0．05）及肿瘤浸润深度（P〈0．05）与T2期直肠癌淋巴结转移有关。多因素分析显示,肿瘤浸润深度是影响T2期直肠癌淋巴结转移的独立因素（P〈0.05）;直肠癌浸润浅肌层和深肌层者淋巴结转移率分别为13．0％（7／54）和27．9％（19／68）。结论对于局限于浅肌层的L期直肠癌,因其淋巴结转移率较低,可考虑行经肛局部切除手术。

Influencing factors related to lymphatic metastasis of T2 rectal carcinoma

Objective To study the risk factors associated with lymphatic metastasis of T2 rectal carcinoma. Methods A consecutive series of 122 patients with T2 rectal cancer who underwent radical surgery in the First Affiliated Hospital of Fujian Medical University from 2006 to 2011 were included for retorspective analysis. Risk factors associated with lymphatic metastasis were investigated. Results The rate of lymph node metastasis was 21.3% （26/122）. Distance to anal verge （P〈0.05）, morphological type（P〈0.05）, histological type（P〈0.05）, tumor differentiation（P〈0.05）, and depth of invasion（P〈0.05） were risk factors for lymph node metastasis in T2 rectal cancer by univariate analysis. The depth of invasion remained statistically significant by multivariate analysis. The rate of lymph node metastasis was 13%（7/54） in patients with shallow muscutaris propria involvement, and 28%（19/68） in those with deep muscularis involvement. Conclusion For T2 rectal cancer with shallow muscularis involvement, the risk of lymph node metastasis is low and transanal excision should be considered.