结直肠癌切除标本的淋巴结是否应全部处理？
Should lymph nodes from colorectal cancer resection specimens be processed in their entirety?
机构信息
Cellular Pathology, Craigavon Area Hospital, Portadown, UK.
出版信息
J Clin Pathol. 2012 Feb;65(2):114-6. doi: 10.1136/jclinpath-2011-200263. Epub 2011 Oct 19.
AIMS
To quantify the benefit of processing each lymph node in its entirety in colorectal cancer specimens.
METHODS
391 consecutive cases were examined retrospectively to assess how often cases were upstaged to node positive disease by examining each node in its entirety.
RESULTS
7 out of 391 patients were upstaged by this method. However, of those patients, approximately three could have been detected by chance. Therefore, approximately 1% of cases were correctly upstaged. However, six of these seven patients also had at least one additional adverse prognostic factor, and would otherwise have been considered high risk Dukes' B cases.
CONCLUSIONS
Processing all slices of each lymph node significantly increases laboratory workload and is of minimal clinical benefit.
目的
量化在结直肠癌标本中完整处理每个淋巴结的获益。
方法
回顾性检查了 391 例连续病例，以评估通过完整检查每个淋巴结来将多少病例升级为淋巴结阳性疾病。
结果
通过这种方法，7 例中有 391 例被升级。然而，这些患者中，大约有三例可能是偶然发现的。因此，大约有 1%的病例被正确升级。然而，这 7 例患者中的 6 例也至少有一个额外的不良预后因素，否则将被认为是高危 Dukes'B 病例。
结论
处理每个淋巴结的所有切片都会显著增加实验室工作量，但临床获益极小。
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