Hong Seung-Mo, Cho HyungJun, Lee Ok-Jun, Ro Jae Y
Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA.
Am J Surg Pathol. 2005 Sep;29(9):1177-83. doi: 10.1097/01.pas.0000160978.77833.d7.
The number of lymph nodes with metastases is known to be an important prognostic factor in carcinomas of many organs. The insufficient sampling of lymph nodes has also been associated with worse outcome in several types of carcinoma. However, the prognostic significance of lymph node dissection is not well characterized in extrahepatic bile duct (EBD) carcinomas. For 209 patients with EBD carcinoma, the total number of retrieved lymph nodes and the number of metastatic lymph nodes were evaluated, and other clinicopathologic variables were correlated with patient survival. The number of retrieved lymph nodes was not significantly correlated with survival in this study. The presence of metastasis to lymph nodes significantly decreased survival of patients with EBD carcinoma. The patients with 5 or more metastatic lymph nodes had significantly worse survival than those with 4 or less metastatic lymph nodes. To evaluate the prognosis of the patients with EBD carcinomas more precisely, the number of metastatic lymph nodes as well as the status of metastasis to lymph nodes should be examined and reported. Based on the present data, we propose that nodal classification should be divided into N1 (metastasis in 1 to 4 regional lymph nodes) and N2 (metastasis in 5 or more regional lymph nodes).
已知有转移的淋巴结数量是许多器官癌的一个重要预后因素。淋巴结采样不足也与几种类型癌症的较差预后相关。然而，肝外胆管（EBD）癌中淋巴结清扫的预后意义尚未得到充分描述。对209例EBD癌患者，评估了获取的淋巴结总数和转移淋巴结数量，并将其他临床病理变量与患者生存率进行关联。在本研究中，获取的淋巴结数量与生存率无显著相关性。淋巴结转移的存在显著降低了EBD癌患者的生存率。有5个或更多转移淋巴结的患者生存率明显低于有4个或更少转移淋巴结的患者。为了更准确地评估EBD癌患者的预后，应检查并报告转移淋巴结的数量以及淋巴结转移状态。基于目前的数据，我们建议将淋巴结分类分为N1（1至4个区域淋巴结转移）和N2（5个或更多区域淋巴结转移）。
