摘要
目的研究直肠癌在直肠远端系膜内播散的规律。方法收集直肠癌根治手术标本60例,整体平铺用溶脂法处理后,绘制淋巴结分布图,逐个定位、计数淋巴结及癌转移结节,显微镜下观察其转移规律。结果直肠癌在直肠远端系膜的播散方式主要为淋巴结转移和癌转移结节形成,远端系膜总播散率为13%(8/60),淋巴结播散率为10%(6/60),癌结节播散率为7%(4/60),播散最远距离为4．5cm。肿瘤大体类型、组织学类型和浸润深度是影响直肠癌远端系膜淋巴结播散的因素。肿瘤部位及Dukes分期是影响直肠癌远端系膜癌转移结节播散的因素。结论利用溶脂法能全面客观地观察直肠远端系膜内癌组织的播散规律。直肠癌手术远端系膜切除距肿瘤下缘不应少于4．5 cm或行全系膜切除。
Objective To study lymph node metastases in the distal mesoreetum in rectal carcinoma patients undergoing radical resection. Methods Surgical specimens of 60 patients with rectal carcinoma were extended to the original size and shape, handled by fat clearing method, lymph nodes and isolated mesenteric cancer nodes were extracted using transillumination and histologically examined for metastases. A map of lymph node and isolated mesenteric cancer node was produced including the site of primary lesion, the vascular distribution, and the site of extracted nodes. Results Distal mesorectal spread of rectal carcinoma included lymph node and isolated mesenteric cancer node metastases. The metastatic rate of total, lymph node and isolated mesenteric cancer loci was 13% （8/60）, 10% （6/60） and 7% （4/60）, respectively, with a distance from the primary cancer of up to 4. 5 cm. Lymph node spread was closely correlated with the gross type, histological grade and infiltrative depth of the primary cancer. Isolated mesenteric cancer loci within the distal mesorectum was closely correlated with the site of the tumor and Dukes stage. Conclusions Fat clearing method provides a panoramic information of distal mesorectal spread in cases of rectal carcinoma. In cases undergoing radical resection for rectal carcinoma, the distal mesorectal excision should exceed 4. 5 cm from the rectal tumor.
出处
《中华普通外科杂志》
CSCD
北大核心
2006年第6期427-430,共4页
Chinese Journal of General Surgery
关键词
直肠肿瘤
淋巴结
肿瘤转移
肠系膜
Rectal neoplasms
Lymph nodes
Neoplasm metastasis
Mesentery
