Nivatvongs S, Rojanasakul A, Reiman H M, Dozois R R, Wolff B G, Pemberton J H, Beart R W, Jacques L F
Department of Surgery, Mayo Medical School, Rochester, Minnesota 55905.
Dis Colon Rectum. 1991 Apr;34(4):323-8. doi: 10.1007/BF02050592.
One hundred fifty-one patients with colorectal polyps containing invasive adenocarcinoma treated by resection were studied to determine the incidence of lymph node metastasis and whether lymph node metastasis was related to the depth of invasion. Other variables evaluated included size and configuration of the polyp, grade of adenocarcinoma, presence or absence of lymphovascular invasion, and degree of differentiation. In patients with sessile polyps, the incidence of lymph node metastasis was 10 percent. Eighty percent of these lesions had lymphovascular invasion. For pedunculated polyps, the overall incidence of lymph node metastasis was 6 percent. However, there was no incidence of lymph node metastasis when the depth of invasion was limited to the head, neck, and stalk of the polyp (Levels 1, 2, and 3). Only when the depth of invasion reached to the base of the stalk (Level 4) was the risk of lymph node metastasis high (27 percent). The other risk factors were not associated with lymph node metastasis. We concluded that the most significant risk factor for lymph node metastasis in patients with invasive carcinoma in a polyp was invasion into the submucosa of the bowel wall (Level 4).
对151例经手术切除的含有浸润性腺癌的大肠息肉患者进行研究，以确定淋巴结转移的发生率以及淋巴结转移是否与浸润深度相关。评估的其他变量包括息肉的大小和形态、腺癌的分级、有无淋巴管浸润以及分化程度。在无蒂息肉患者中，淋巴结转移的发生率为10%。这些病变中有80%存在淋巴管浸润。对于有蒂息肉，淋巴结转移的总体发生率为6%。然而，当浸润深度仅限于息肉的头部、颈部和蒂部（1级、2级和3级）时，无淋巴结转移发生。仅当浸润深度达到蒂部基部（4级）时，淋巴结转移风险才高（27%）。其他危险因素与淋巴结转移无关。我们得出结论，息肉中浸润性癌患者发生淋巴结转移的最显著危险因素是侵犯肠壁黏膜下层（4级）。
