Chen Wei-Rong, Chen Mao-Gen, Cai Gao-Yang, Liao Zi-Qun
Department of General Surgery, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2008 Mar;11(2):136-40.
To study the the relationship between lymphatic vessel density (LVD) and distal intramural spread (DIS), and evaluate the value of LVD in determining the length of distal resection in low rectal cancer.
Ninety-two samples from patients undergone curative resection of low rectal cancer were studied. DIS was detected by HE stain. LVD was examined by immunohisto-chemical LYVE-1 (lymphatic vessel endothelial hyaluronan receptor). The association of LVD with DIS and other clinicopathological factors were examined.
DIS (range 0.1-2.4 cm, mean 0.31 cm) was present in 44(47.8%) patients with low rectal cancer, including 23(52.3%) cases with cancer emboli in lymphatic vessels. LVD of peritumoral lesion was significantly higher than that of intratumoral lesion. LVD of DIS subgroup was significantly higher than that of non-DIS subgroup. Positive correlation was found by rank correlation test between the length of DIS and the LVD at peritumor tissue in DIS group (n=44, r=0.755, P<0.01). LVD was also positively correlated with the infiltration extent, lymphatic invasion and lymph node metastasis.
Lymphangiogenesis plays an important role in rectal cancer metastasis and cancer emboli in lymphatic vessels is the most common modality of DIS. The LVD is positively correlated with DIS, which may be helpful to determine the distal clearance length of rectal cancer.
研究淋巴管密度（LVD）与远端壁内扩散（DIS）之间的关系，并评估LVD在确定低位直肠癌远端切除长度中的价值。
对92例接受低位直肠癌根治性切除的患者样本进行研究。通过苏木精-伊红（HE）染色检测DIS。采用免疫组织化学法用LYVE-1（淋巴管内皮透明质酸受体）检测LVD。检测LVD与DIS及其他临床病理因素的相关性。
44例（47.8%）低位直肠癌患者存在DIS（范围0.1 - 2.4 cm，平均0.31 cm），其中23例（52.3%）有淋巴管癌栓。肿瘤周围病变的LVD显著高于肿瘤内病变。DIS亚组的LVD显著高于非DIS亚组。在DIS组中，DIS长度与肿瘤周围组织的LVD经等级相关检验呈正相关（n = 44，r = 0.755，P < 0.01）。LVD还与浸润范围、淋巴侵犯及淋巴结转移呈正相关。
淋巴管生成在直肠癌转移中起重要作用，淋巴管癌栓是DIS最常见的形式。LVD与DIS呈正相关，这可能有助于确定直肠癌的远端切缘长度。
