直肠癌单个转移淋巴结分布情况及临床意义

目的：通过回顾性分析直肠癌单个转移淋巴结的病理情况,预测直肠癌前哨淋巴结（SLN）的分布,为下一步行前瞻性研究提供参考。方法：收集1994年10月—1999年10月行根治性切除的68例直肠癌患者,其病理检查结果均为单个淋巴结转移,分析转移淋巴结的解剖位置,推断直肠癌SLN分布情况。结果：68例患者共计淋巴结720枚,平均每例10.59枚（3～26枚）。单个转移淋巴结分布情况结果显示肠旁淋巴结转移（肠旁组）52例（76.5%）,中间淋巴结转移（中间组）12例（17.6%）,中央淋巴结转移（中央组）4例（5.9%）。非肠旁组织转移的＂跳跃＂转移（SM）共计16例（23.5%）。随着直肠癌组织浸润肠壁深度的增加、肿瘤直径的增大以及分化程度的变差,SM亦呈升高趋势（P〈0.05）,SM与肿瘤位置无明显相关性（P〉0.05）。结论：大部分直肠癌SLN分布于肠旁,极少部分可出现＂跳跃＂转移现象,分布于肠系膜血管周围。

Solitary metastatic lymph node distribution and its clinical significance in rectal carcinoma

Objective： To investigate the solitary metastatic lymph node distribution and its clinical significance in rectal carcinoma and to provide novel methods for further prospective study. Methods： Between October 1994 and October 1999, 68 consecutive patients undergoing resection for clinically localized rectal carcinoma were enrolled. The distribution of solitary metostatic lymph node was analysized. Results： A total of 720 nodes （average 10.59 per patient; range 3 to 26） were identified in this study group. The solitary metastatic nodes were found in the nearest pericolorectal nodal area in 76.5%（52/68）of cases and 16（23.5%）of rectal cancer were＂skip＂metastasis （SM）. ＂Skip＂metastasis was correlated with tumor diameter, infiltrative depth and differentiation （P〈0.05）. No significant difference was found between ＂skip＂metastasis and site of tumor. Conclusion： The location of SLN in rectal cancer is random and multidirectional, and the rate o＂fskip＂ metastasis is much higher than expected.