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淋巴结转移数目在结直肠癌预后判断中的意义 被引量:1

Rely on the Number of Lymphnode Metastasis for Extimating Prognosis of Colorectal Cancer Alone
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摘要 目的 :AJCC/ UICC TNM分期公布已 13年 ,国际上已得广泛应用 ,但国内至今未见用引分期文献报道。这种分期也不太严谨 ,未规定淋巴结检查数目和每枚淋巴结切片数。因此 ,研究结直肠癌淋巴结转移 (L NM)数目与预后的关系可弥补其不足。方法 :用自制的病理检查规范检查结直肠癌的淋巴结 ,分期采用AJCC/ U ICC TNM系统 ,同时作 Dukes分期 ,比较两种分期。结果 :76例共查淋巴结 3885枚 ,每例平均 5 1.5 2± 2 3.15枚。 4 3例有 L NM,L NM率为 5 6 .5 8%。N1 和 N2 病例 5年生存率有高度显著差别。L NM≥ 10枚和/或顶端、主干血管旁 L NM病例的预后极差。结论 :AJCC/ UICC TNM分期优于 Dukes分期 ;AJCC/ UICCTNM分期也有不足 ; Objective: TNM stage system of colorectal cancer was published by AJCC/UICC 13 years ago and used widely all the world over. Yet no artical was presented in domestic literature until now. AJCC/UICC TNM stage system was imprecisely also, the number of nodes must be examined had not defined and the number of slices for each node Thus, It will be help to study the relationship between the number of LNM and nor the prognosis in colorectal cancer. Methods: The operative specimens of colorectal cancer were examined according to the pathologic rule estabished by ourselves. The stage was taken according to AJCC/UICC TNM system and Dukes stage and the comparison was made between two stages system. Results: A total 3885 nodes were harvested from 76 cases. An average of 51.52±23.15 nodes for each case were harvested. 43 patients shown LNM with a ratio of LNM 56.58%. The prognosis of patients with N1 stage was much better than that of patients with N2 stage. When prominent nodes or nodes beside named vessels show metatasis and the number of LNM more than or equal to 10, the prognosis was very poor. Conclusion: AJCC/UICC TNM stage system shown much better prediction than Dudes stage. Nevertheless, the shortages of AJCC/UICC TNM system existed clearly. Thus, we bring forward a new stage system in colorectal cancer.
出处 《江汉大学学报(医学版)》 2002年第1期21-24,共4页 Journal of Wuhan Professional Medical College
关键词 结肠癌 淋巴结转移数目 直肠癌 预后 colorectal cancer lymphnode metastasis prognosis
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参考文献6

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同被引文献11

  • 1张玉科,董新舒,赵家宏,刘福盛,赵廷忠,丁立.大肠癌淋巴转移特点[J].实用肿瘤杂志,1989,4(3):134-136. 被引量:3
  • 2佟金学,张玉科,赵家宏,丁立.结肠癌淋巴转移与病理因素关系探讨[J].中国肿瘤临床,1995,22(12):866-868. 被引量:4
  • 3韩洪秋,刘彤,赵丽中,戚峰,王鹏志.国际新的TNM分期对分析结直肠癌预后的临床意义[J].中华医学杂志,2006,86(12):819-821. 被引量:14
  • 4赵东兵,高纪东,单毅,周志祥,袁兴华,吴健雄,邵永孚.结肠癌根治术后转移复发的特点及预后分析[J].中华胃肠外科杂志,2006,9(4):291-293. 被引量:36
  • 5李力人,万德森,潘志忠,周志伟,陈功,伍小军,卢震海.大肠癌淋巴结转移对预后的影响[J].广东医学,2006,27(12):1819-1821. 被引量:3
  • 6Carlos A, Victor Im, Gustavo L, et al. l.ymph Node Ratio as Prognosis Factor for Colon Cancer Treated by Colorectal Surgeons[J].Dis Colon rectum, 2009, 52(7) : 1244-1250.
  • 7Kelder W, Inberg B, Schaapveld M, et al. Impact of the Number of Histologically Examined Lymph Nodes on Prognosis in Colon Cancer: A Population-Based Study in The Netherlands [J]. Dis Colon Rectum, 2009, 52(2): 260-267.
  • 8Chok KS, Law WL. Prognostic factors affecting survival and recurrence of patients with pT1 and pT2 colorectal cancer[J]. World J Surg, 2007, 31(7): 1485-1490.
  • 9Halsted W. The results of operations for the cure of cancer of the breast performed at the Johns Hopkins Hospital from June 1889 to Jannuary, 1894[J]. Ann Surg, 1894, 20(5): 497-555.
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