| 低位直肠癌直肠系膜淋巴结转移规律的临床探讨 |
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| 引用本文： | 谢本长,余枭,唐华勇,贺孝文.低位直肠癌直肠系膜淋巴结转移规律的临床探讨[J].中国现代手术学杂志,2011,15(1):10-12. |
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| 作者姓名： | 谢本长 余枭 唐华勇 贺孝文 |
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| 作者单位： | 1. 湖南省武冈市展辉医院外一科,武冈,422400
2. 中南大学湘雅三医院胃肠外科,长沙,410013 |
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| 基金项目： | 湖南省自然科学基金资助项目 |
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| 摘 要： | 目的探讨低位直肠癌直肠系膜淋巴结转移与临床病理特点的关系。方法对62例行直肠系膜全切除（total mesorectal excision,TME）的低位直肠癌采用大组织切片技术检测直肠系膜淋巴结转移情况,分析其转移规律。结果低位直肠癌系膜转移率为72.6%（45/62）（其中系膜淋巴结阳性29例,系膜癌巢阳性16例）。①不同临床病理类型的系膜转移率为：肿瘤直径≥5 cm者为90.5%（19/21）,明显高于肿瘤直径〈5 cm的63.4%（26/41）（P〈0.05）。②T1、T2和T3期者分别为22.2%（2/9）、68.0%（17/25）和92.9%（26/28）,组内两两比较具有显著性差异（P〈0.05或P〈0.01）。③高、中、低分化者为14.3%（1/7）7、9.5%（31/39）和81.3%（13/16）,高分化者明显低于中、低分化者（P〈0.05）。④Ⅰ、Ⅱ、Ⅲ期者分别为11.1%（1/9）、63.6%（14/22）和96.8%（30/31）,Ⅰ期者明显低于Ⅱ、Ⅲ期者（P〈0.05）。⑤环周切缘阳性者为93.3%（14/15）,明显高于环周切缘阴性者66.0%（31/47）（P〈0.05）。直肠系膜转移率与患者性别、年龄、肿瘤侵袭肠壁周径、Ming分型无关（P〉0.05）。结论低位直肠癌直肠系膜淋巴结转移与肿瘤直径、浸润深度、分化程度和肿瘤分期密切相关;环周切缘阳性者,其直肠系膜淋巴结转移的可能性越高。因此,低位直肠癌应遵循彻底TME原则。
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| 关 键 词： | 直肠肿瘤 淋巴转移 |
The Mesorectal Metastasis of Lower Rectal Cancer |
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| XIE Ben-chang,YU Xiao,TANG Hua-yong,HE Xiao-wen.The Mesorectal Metastasis of Lower Rectal Cancer[J].Chinese Journal of Modern Operative Surgery,2011,15(1):10-12. |
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| Authors: | XIE Ben-chang YU Xiao TANG Hua-yong HE Xiao-wen |
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| Institution: | XIE Ben-chang,YU Xiao,TANG Hua-yong,HE Xiao-wen(Department of the First General Surgery,Wugang Zhanhui Hospital,Wugang 422400,Hunan,China) |
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| Abstract: | Objective To investigate the mesorectal metastasis of lower rectal cancer and evaluate its relationship with clinicopathologic characteristics.Methods Cancer specimens resected from 62 patients with lower rectal cancer who received total mesorectal excision(TME) were examined by routine pathologic observation.The relationship between mesorectal metastasis and clinicopathologic characteristics of lower rectal cancer was investigated.Results Mesorectal metastasis was detected in 45 of 62 cancer specimens(72.6... |
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| Keywords: | rectal neoplasms lymphatic metastasis |
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