Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
Ann Surg Oncol. 2011 Jan;18(1):146-52. doi: 10.1245/s10434-010-1270-2. Epub 2010 Aug 24.
For patients with cecal and ascending colonic cancers, the significance of regional lymph node (LN) metastasis at the terminal ileum has not been elucidated. We analyzed its metastatic patterns and significance.
The records of patients with cecal and ascending colonic cancers receiving standard radical right hemicolectomy with D3 LN dissection between 2000 and 2010 were collected. The regional LNs were grouped according to the Japanese Classification of Colorectal Carcinoma. The regional LNs supplied by ileocolic vessels were further divided into 201-A (terminal ileal side) and 201-B (colonic side). The clinicopathologic characteristics of all cases showing positive for metastasis in 201-A LN were analyzed.
Forty-seven cases of cecal and 56 cases of ascending colonic cancer were included. Seven cases had 201-A-positive LNs: five (10.6%) in cecal cancers and two (3.6%) in ascending colonic cancers. They all had distant metastases (P < 0.001), and the incidences were significantly correlated with the numbers of metastatic LNs (P < 0.05). There was no 201-A-positive LN noted among patients with stage I to III disease. Poor prognosis was noted for patients with a 201-A-positive LN.
Both cecal and ascending colonic cancers have a potential for LN metastasis at the terminal ileum. These cases are exclusively stage IV and have poor prognosis.
对于盲肠和升结肠癌患者，末端回肠区域淋巴结（LN）转移的意义尚未阐明。我们分析了其转移模式和意义。
收集了 2000 年至 2010 年间接受标准根治性右半结肠切除术和 D3 LN 清扫术的盲肠和升结肠癌患者的病历。根据日本大肠癌分类法对区域淋巴结进行分组。回结肠血管供应的区域淋巴结进一步分为 201-A（末端回肠侧）和 201-B（结肠侧）。分析所有在 201-A 淋巴结转移阳性的病例的临床病理特征。
纳入 47 例盲肠癌和 56 例升结肠癌。7 例 201-A 阳性淋巴结：5 例（10.6%）为盲肠癌，2 例（3.6%）为升结肠癌。它们均有远处转移（P<0.001），且转移淋巴结数量与发生率显著相关（P<0.05）。I 期至 III 期疾病患者中未见 201-A 阳性淋巴结。201-A 阳性淋巴结患者预后不良。
盲肠和升结肠癌均有末端回肠 LN 转移的潜力。这些病例均为 IV 期，预后不良。
