结直肠癌淋巴结微转移对预后影响的意义

背景与目的:淋巴结微转移的预后价值尚无一致意见,本研究旨在探讨结直肠癌淋巴结微转移的预后意义。方法:收集江汉大学附属医院1988年～2001年结直肠癌根治性手术切除、有完整淋巴结检查资料的标本80例,其中直肠癌30例,结肠癌50例。经过溶脂法检查淋巴结共3869枚,平均每例48.36枚,经4μm间断连续切片、常规HE染色和免疫组化染色,确定有无淋巴结转移与微转移(微转移灶为瘤团直径<0.2mm或瘤细胞数<50个)。数据经SAS8.1统计学软件进行Cox模型回归分析及Spearman等级相关分析。结果:共检出转移淋巴结232枚(6%),微转移淋巴结39枚(1.01%)。直肠癌中淋巴结转移数与患者生存时间有关(χ2=9.94,P=0.0016);淋巴结微转移与淋巴结转移数(r=0.44,P=0.016)等病理学指标有关。结肠癌中淋巴结转移数(χ2=9.52,P=0.002)、AJCC淋巴结分期(χ2=5.73,P=0.0167)与患者生存时间有关,淋巴结微转移与Dukes’淋巴结分期(r=0.314,P=0.008)有关。结论:淋巴结微转移与结直肠癌预后相关,但不能作为独立的预后指标。

Prognostic significance of lymph node micrometastasis in colorectal cancer

BACKGROUND & OBJECTIVE: There have been many controversies about the prognostic significance of lymph node micrometastasis. The aim of this study was to characterize the prognostic significance of lymph node micrometastasis of colorectal cancer. METHODS: Specimens of curative resection between 1988 and 2001 were collected from The Affiliated Hospital of Jianghan University Medical and Life Science College. All 80 patients (30 cases of rectal cancer, 50 cases of colon cancer) had complete examination data. A total of 3869 lymph nodes (48.36 per case) were found by clearing fat method. The interrupted serial 4-micron sections, routine hematoxylin and eosin staining and immunohistochemistry methods were used to detect the lymph node metastasis and micrometastasis (small tumor cells cluster diameter