Takeshima Nobuhiro, Hirai Yasuo, Umayahara Kenji, Fujiwara Kiyoshi, Takizawa Ken, Hasumi Katsuhiko
Department of Gynecology, Cancer Institute Hospital, 3-10-6, Ariake, Koto-ku, Tokyo 135-8550, Japan.
Gynecol Oncol. 2005 Nov;99(2):427-31. doi: 10.1016/j.ygyno.2005.06.051. Epub 2005 Aug 19.
To investigate the lymph node sites most susceptible to involvement relative to primary tumor histology in ovarian cancer.
The locations of metastatic lymph nodes were investigated in 208 patients with primary ovarian cancer who underwent systemic lymphadenectomy covering both the pelvic and para-aortic regions.
Lymph node metastasis was present in 12.8% (20/156) of patients with stage I (pT1M0), 48.6% (18/37) with stage II (pT2M0), and 60% (9/15) with stage III (pT3M0) disease, thus in 22.6% (47/208) of all study patients. Isolated para-aortic nodal involvement was present in 23.3% (14/60) of patients with serous tumor and 4.1% (6/148) of those with non-serous tumor (P = 0.00002). In an analysis of 35 positive nodes from 25 patients with up to 3 positive nodes, 86.4% (19/22) of metastatic lymph nodes from patients with serous tumor were found in the para-aortic region, with 14 positive nodes located above the inferior mesenteric artery (IMA) and 5 below it, whereas metastasis to para-aortic lymph nodes accounted for 53.8% (7/13) of metastatic lymph nodes from patients with non-serous tumor (P = 0.0334).
The locations of metastatic lymph nodes in ovarian cancer depend upon the histologic type of the primary cancer. In cases of serous tumor, the para-aortic region, particularly above the IMA, is the prime site for the earliest lymph node metastasis. However, the likelihood of pelvic node involvement is almost equal to that of para-aortic node involvement in cases of non-serous tumor.
研究相对于卵巢癌原发肿瘤组织学而言，最易受累的淋巴结部位。
对208例行盆腔和腹主动脉旁区域系统性淋巴结清扫术的原发性卵巢癌患者的转移淋巴结位置进行研究。
Ⅰ期（pT1M0）患者中12.8%（20/156）有淋巴结转移，Ⅱ期（pT2M0）患者中48.6%（18/37）有淋巴结转移，Ⅲ期（pT3M0）患者中60%（9/15）有淋巴结转移，所有研究患者中22.6%（47/208）有淋巴结转移。浆液性肿瘤患者中23.3%（14/60）有孤立性腹主动脉旁淋巴结受累，非浆液性肿瘤患者中4.1%（6/148）有孤立性腹主动脉旁淋巴结受累（P = 0.00002）。在对25例最多有3个阳性淋巴结的患者的35个阳性淋巴结进行分析时，浆液性肿瘤患者转移至腹主动脉旁区域的淋巴结占转移淋巴结的86.4%（19/22），其中14个阳性淋巴结位于肠系膜下动脉（IMA）上方，5个位于其下方，而非浆液性肿瘤患者转移至腹主动脉旁淋巴结的占转移淋巴结的53.8%（7/13）（P = 0.0334）。
卵巢癌转移淋巴结的位置取决于原发癌的组织学类型。对于浆液性肿瘤，腹主动脉旁区域，尤其是IMA上方，是最早发生淋巴结转移的主要部位。然而，在非浆液性肿瘤病例中，盆腔淋巴结受累的可能性与腹主动脉旁淋巴结受累的可能性几乎相等。
