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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.

DOI:10.1136/jclinpath-2011-200263
PMID:22011451
Abstract

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.

摘要

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。

相似文献

1
Should lymph nodes from colorectal cancer resection specimens be processed in their entirety?结直肠癌切除标本的淋巴结是否应全部处理?
J Clin Pathol. 2012 Feb;65(2):114-6. doi: 10.1136/jclinpath-2011-200263. Epub 2011 Oct 19.
2
Lymph node recovery from colorectal tumor specimens: recommendation for a minimum number of lymph nodes to be examined.结直肠肿瘤标本的淋巴结回收:关于建议检查的最少淋巴结数量
World J Surg. 2002 Mar;26(3):384-9. doi: 10.1007/s00268-001-0236-8. Epub 2002 Jan 15.
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How many lymph nodes should be examined in Dukes' B colorectal cancer? Determination on the basis of cumulative survival rate.在杜克B期结直肠癌中应检查多少个淋巴结?基于累积生存率的判定。
Hepatogastroenterology. 2005 Nov-Dec;52(66):1703-6.
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Improvement of 10-year survival by Japanese radical lymph node dissection in patients with Dukes' B and C colorectal cancer: a 17-year retrospective study.日本根治性淋巴结清扫术对Dukes' B期和C期结直肠癌患者10年生存率的改善:一项17年的回顾性研究。
Oncol Rep. 2003 Jul-Aug;10(4):927-34.
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Impact of Schwartz enhanced visualization solution on staging colorectal cancer and clinicopathological features associated with lymph node count.施瓦茨增强可视化解决方案对结直肠癌分期和与淋巴结计数相关的临床病理特征的影响。
Dis Colon Rectum. 2013 Sep;56(9):1028-35. doi: 10.1097/DCR.0b013e31829c41ba.
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Limited lymph-node recovery based on lymph-node localisation is sufficient for accurate staging.基于淋巴结定位的有限淋巴结取样足以进行准确分期。
J Clin Pathol. 2011 Jan;64(1):13-5. doi: 10.1136/jcp.2010.083006. Epub 2010 Oct 14.
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Lymph node preparation in resected colorectal carcinoma specimens employing the acetone clearing method.采用丙酮透明法对切除的结直肠癌标本进行淋巴结制备。
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Variance of surgeons versus pathologists in staging of colorectal cancer.结直肠癌分期中外科医生与病理学家之间的差异
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For patients with Dukes' B (TNM Stage II) colorectal carcinoma, examination of six or fewer lymph nodes is related to poor prognosis.对于患有杜克B期(TNM分期II期)结直肠癌的患者,检查六个或更少的淋巴结与预后不良有关。
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10
Better retrieval of lymph nodes in colorectal resection specimens by pathologists' assistants.病理助手可提高结直肠切除标本中淋巴结的检出率。
J Clin Pathol. 2013 Jan;66(1):18-23. doi: 10.1136/jclinpath-2012-201089. Epub 2012 Oct 19.

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