Tu Shi-liang, Ye Zai-yuan, Deng Gao-li, Zhao Zhong-sheng, Dong Quan-jin, Zheng Bo-an, Ding Li-ping, Cao Hong-feng
Department of General Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2007 May;10(3):257-60.
To investigate the rule of lymph node metastasis in colorectal cancer and its affecting factors, and to provide clues for clinical diagnosis and treatment of colorectal cancer patients.
The clinical data of 1166 cases of colorectal cancer receiving surgical resection were analyzed retrospectively.The relationships between clinicopathologic variables and lymph node metastases were evaluated by crosstabs and logistic regression in SPSS 10.0 for windows.
The rate of lymph node metastasis in colorectal cancer was 49.7%. After entering crosstabs estimation, gender and tumor site were not significantly correlated with lymph node metastasis in colorectal cancer(chi2=1.46, r=0.035, P>0.05 and chi2=3.86, r=0.012, P>0.05). Age, tumor size, the massive type of the tumor, the differentiating degree of the tumor, histology type and the depth of tumor invasion were proved to be independent factors influencing the lymph node metastasis in colorectal cancer (chi2 =13.1, r=0.064, P<0.05 and chi2=77.161, r=0.245, P<0.01 and chi2=144.831, r=0.341, P<0.01 and chi2=128.310, r=0.318, P<0.01 and chi2=120.418, r=0.319, P<0.01 and chi2=227.287, r=0.434, P<0.01). After entering logistic regression estimation, the correlativity of risk factor of lymph node metastasis in colorectal cancer: the depth of tumor invasion > the massive type of the tumor>the differentiating degree of the tumor > tumor size. Preoperative blood serum CEA level was significantly correlated with lymph node metastasis (chi2=509.599, r=0.661, P<0.01).
The depth of tumor invasion is the most risk factor of lymph node metastasis in colorectal cancer. Preoperative high level of blood serum CEA indicates the occurrence of lymph node metastasis.
探讨结直肠癌淋巴结转移规律及其影响因素，为结直肠癌患者的临床诊断与治疗提供线索。
回顾性分析1166例接受手术切除的结直肠癌患者的临床资料。在SPSS 10.0 for windows软件中，通过交叉表和逻辑回归分析评估临床病理变量与淋巴结转移之间的关系。
结直肠癌淋巴结转移率为49.7%。经交叉表评估后，性别和肿瘤部位与结直肠癌淋巴结转移无显著相关性（χ2=1.46，r=0.035，P>0.05；χ2=3.86，r=0.012，P>0.05）。年龄、肿瘤大小、肿瘤大体类型、肿瘤分化程度、组织学类型和肿瘤浸润深度被证明是影响结直肠癌淋巴结转移的独立因素（χ2 =13.1，r=0.064，P<0.05；χ2=77.161，r=0.245，P<0.01；χ2=144.831，r=0.341，P<0.01；χ2=128.310，r=0.318，P<0.01；χ2=120.418，r=0.319，P<0.01；χ2=227.287，r=0.434，P<0.01）。经逻辑回归评估后，结直肠癌淋巴结转移危险因素的相关性为：肿瘤浸润深度>肿瘤大体类型>肿瘤分化程度>肿瘤大小。术前血清癌胚抗原（CEA）水平与淋巴结转移显著相关（χ2=509.599，r=0.661，P<0.01）。
肿瘤浸润深度是结直肠癌淋巴结转移的最主要危险因素。术前血清CEA水平升高提示淋巴结转移的发生。
