pT1 和 pT2 期直肠癌淋巴结转移的危险因素：943 例单中心经验及文献复习。
Risk factors for lymph node metastasis in pT1 and pT2 rectal cancer: a single-institute experience in 943 patients and literature review.
机构信息
Department of Surgery, Colorectal Section, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
出版信息
Ann Surg Oncol. 2012 Aug;19(8):2477-84. doi: 10.1245/s10434-012-2303-9. Epub 2012 Mar 7.
BACKGROUND
Local excision has become an alternative for radical resection in rectal cancer for selected patients. The purpose of this study was to assess the clinicopathologic factors determining lymph node metastasis (LNM) in patients with T1-2 rectal cancer.
METHODS
Between January 1995 and December 2009, a total of 943 patients with pT1 or pT2 rectal adenocarcinoma received radical resection at a single institution. Clinicopathologic factors were evaluated by univariate and multivariate analyses to identify risk factors for LNM.
RESULTS
A total of 943 patients (544 men and 399 women) treated for T1-2 rectal cancer were included in this study. LNM was found in 188 patients (19.9%). In multivariate analysis, lymphovascular invasion (LVI; P < 0.001, hazard ratio 11.472), poor differentiation (PD; P = 0.007, hazard ratio 3.218), and depth of invasion (presence of pT2; P = 0.032, hazard ratio 1.694) were significantly related to nodal involvement. The incidence for LNM lesions in the presence of LVI, PD, and pT2 was 68.8, 50.0, and 23.1%, respectively, while that for pT1 carcinomas with no LVI or PD was 7.5%.
CONCLUSIONS
LVI, PD, and pT2 are independent risk factors predicting LNM in pT1-2 rectal carcinoma.
背景
局部切除术已成为某些直肠癌患者的一种替代根治性切除术的方法。本研究的目的是评估决定 T1-2 期直肠癌患者淋巴结转移（LNM）的临床病理因素。
方法
1995 年 1 月至 2009 年 12 月期间，一家机构共对 943 例 pT1 或 pT2 直肠腺癌患者进行了根治性切除术。通过单因素和多因素分析评估临床病理因素，以确定 LNM 的危险因素。
结果
本研究共纳入 943 例（544 名男性和 399 名女性）接受 T1-2 期直肠腺癌治疗的患者。188 例（19.9%）患者发现 LNM。多因素分析显示，淋巴管血管侵犯（LVI；P<0.001，风险比 11.472）、分化差（PD；P=0.007，风险比 3.218）和浸润深度（存在 pT2；P=0.032，风险比 1.694）与淋巴结受累显著相关。存在 LVI、PD 和 pT2 时 LNM 病变的发生率分别为 68.8%、50.0%和 23.1%，而无 LVI 或 PD 的 pT1 癌的发生率为 7.5%。
结论
LVI、PD 和 pT2 是预测 pT1-2 期直肠癌 LNM 的独立危险因素。
Zotero 插件