Department of Surgery, School of Medicine, Kurume University, Fukuoka, Japan.
Anticancer Res. 2013 Jul;33(7):2965-70.
The degree of lymph node metastasis represents an important prognostic factor for cancer. Lymphovascular invasion is a traditional tool for estimating the aggressiveness of colorectal cancer.
To determine correlations between lymphatic invasion and lymph node metastasis or disease stage, and clarify the prognostic impact of lymphatic invasion.
Patients (N=1,616) who underwent curative resection of primary colorectal adenocarcinoma at the Kurume University Hospital were included. Lymphatic invasion was calculated as an average and the degree was also determined (Ly0-3). Clinicopathological factors including lymphatic invasion were assessed by uni- and multivariate analyses to determine factors affecting survival. Survival was compared between different degrees of lymphatic invasion and lymph node metastasis.
Lymphatic invasion was absent (Ly0) in 806 patients (50%), and lymph node metastasis was absent (N0) in 1,085 patients (67%). Ninety-one percent of N0 patients were Ly0-1, 72% of N1 were Ly0-1, and 54% of N2 were Ly2-3. All patients with stage 0 disease (100%) were Ly0, 95% of stage I were Ly0-1, 46% of stage II were Ly1-2, and 36% of stage III were Ly2-3. Five- and 10-year survival rates were 83% and 68% in Ly0, 73% and 56% in Ly1, 66% and 49% in Ly2, 63% and 48% in Ly3, 81% and 67% in N0, 69% and 57% in N1, and 60% and 52% in N2, respectively (p<0.0001 each).
Lymphatic invasion in colorectal cancer correlates well with the status of lymph node metastasis and disease stage, representing an independent prognostic factor after curative resection. Lymphatic invasion can be used for evaluating tumor aggressiveness and estimating patient survival, irrespective of the actual number of positive lymph nodes found.
淋巴结转移程度是癌症的一个重要预后因素。淋巴管浸润是评估结直肠癌侵袭性的传统工具。
确定淋巴管浸润与淋巴结转移或疾病分期之间的相关性，并阐明淋巴管浸润的预后影响。
纳入在久留米大学医院接受原发性结直肠腺癌根治性切除术的患者（N=1616）。淋巴管浸润程度计算为平均值，并确定程度（Ly0-3）。通过单因素和多因素分析评估包括淋巴管浸润在内的临床病理因素，以确定影响生存的因素。比较不同淋巴管浸润程度和淋巴结转移患者的生存情况。
806 例患者（50%）淋巴管浸润缺失（Ly0），1085 例患者（67%）淋巴结转移缺失（N0）。91%的 N0 患者 Ly0-1，72%的 N1 患者 Ly0-1，54%的 N2 患者 Ly2-3。所有 0 期疾病患者（100%）均为 Ly0，I 期患者 95%为 Ly0-1，II 期患者 46%为 Ly1-2，III 期患者 36%为 Ly2-3。Ly0 的 5 年和 10 年生存率分别为 83%和 68%，Ly1 为 73%和 56%，Ly2 为 66%和 49%，Ly3 为 63%和 48%，N0 为 81%和 67%，N1 为 69%和 57%，N2 为 60%和 52%（均<0.0001）。
结直肠癌的淋巴管浸润与淋巴结转移和疾病分期密切相关，是根治性切除术后的独立预后因素。淋巴管浸润可用于评估肿瘤侵袭性和估计患者生存情况，而与实际检出的阳性淋巴结数量无关。
