Umetani H
First Department of Surgery, Kurume University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1990 Oct;91(10):1567-73.
We investigated the route of lymphogenous metastasis of cardiac cancer to the diaphragm, making a model of cardiac cancer using VX2 tumor of rabbit. Metastasis ratio of each lymph node in the experimental model indicated a correlation with clinical cases. Histological investigation of the diaphragm indicated floating of VX2 cancer cells in the lymph vessels in the diaphragm in 4 of 20 cases (20%). After, injection of CH44 at the oral side of the tumor, the presence of CH44 in the lymph vessels in the diaphragm were seen in 6 of 16 cases (37.5%). Clinically, the left diaphragm was excised as wide as possible in 22 cases of cardiac cancer with esophageal invasion by left thoraco abdominal approach. Histologically, embolic of the tumor or floating tumor cells in the lymph vessels in the diaphragm were seen in 6 of 22 cases (27.3%). These results revealed that carcinoma proliferating in the cardia can apparently spread to the diaphragm more extensively than has been previous believed.
我们利用兔VX2肿瘤制作贲门癌模型，研究贲门癌向膈肌的淋巴转移途径。实验模型中各淋巴结的转移率与临床病例存在相关性。对膈肌的组织学研究表明，20例中有4例（20%）膈肌淋巴管内可见VX2癌细胞漂浮。在肿瘤口腔侧注射CH44后，16例中有6例（37.5%）在膈肌淋巴管内发现CH44。临床上，对22例经左胸腹部入路侵犯食管的贲门癌患者尽可能广泛地切除左侧膈肌。组织学检查发现，22例中有6例（27.3%）膈肌淋巴管内可见肿瘤栓子或漂浮的肿瘤细胞。这些结果表明，发生在贲门的癌肿向膈肌的扩散明显比以往认为的更为广泛。
