Zhou Yan-bing, Zhuo Hong-qing, Li Li-li, Lv Liang, Li Yu-jun, Zhou Jian
Department of General Surgery, Qingdao University Medical School Hospital, Qingdao 266003, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2009 Mar;12(2):159-62.
To study the relationship between the degree of mesorectal tumor invasion and prognosis of the patients with middle-low rectal cancer.
Specimens from 49 patients with middle-low rectal cancer, undergone total mesorectal excision in our hospital from April 2003 to December 2003,were studied by large slice pathologic technique. The thickness of mesorectum and the depth of tumor infiltration were measured, and the degree of mesorectal tumor invasion was calculated. The local recurrence rate, metastasis rate and 5-year survival rate were investigated respectively. Possible clinicopathological influence factors were also analyzed.
The local recurrence rate was 12.2%(6/49), the distant metastasis rate was 26.5%(13/49). In three different degrees of mesorectal tumor invasion(I(,II(,III(), the local recurrence rates were 0, 7.7% and 31.3% (chi(2)=7.357, P =0.015); the metastasis rates were 10%, 23.1% and 50%(chi(2)=7.405, P =0.025); the 5-year survival rates were 90.9%, 69.2% and 28.6%(log-rank, P =0.013). Tumor diameter, T and N staging were risk factors influencing the degree of mesorectal tumor invasion(chi(2)=6.849 P=0.033, chi(2)=34.845 P =0.000, chi(2)=17.266 P =0.002).
The degree of mesorectal tumor invasion is an important predictor of local and distant metastasis as well as survival of patients in middle-low rectal carcinoma. The degree of mesorectal tumor invasion in the middle-low rectal carcinoma is significantly correlated with tumor diameter, T and N stage.
研究中低位直肠癌患者直肠系膜肿瘤浸润程度与预后的关系。
采用大切片病理技术对2003年4月至2003年12月在我院行全直肠系膜切除术的49例中低位直肠癌患者的标本进行研究。测量直肠系膜厚度和肿瘤浸润深度,计算直肠系膜肿瘤浸润程度。分别调查局部复发率、转移率和5年生存率。还分析了可能的临床病理影响因素。
局部复发率为12.2%(6/49),远处转移率为26.5%(13/49)。在直肠系膜肿瘤浸润的三种不同程度(I、II、III)中,局部复发率分别为0、7.7%和31.3%(χ²=7.357,P =0.015);转移率分别为10%、23.1%和50%(χ²=7.405,P =0.025);5年生存率分别为90.9%、69.2%和28.6%(对数秩检验,P =0.013)。肿瘤直径、T和N分期是影响直肠系膜肿瘤浸润程度的危险因素(χ²=6.849,P=0.033;χ²=34.845,P =0.000;χ²=17.266,P =0.002)。
直肠系膜肿瘤浸润程度是中低位直肠癌患者局部和远处转移以及生存的重要预测指标。中低位直肠癌的直肠系膜肿瘤浸润程度与肿瘤直径、T和N分期显著相关。