Ferko A, Orhalmi J, Dusek T, Chobola M, Hovorkova E, Hadzi Nikolov D, Dolejs J
Department of Surgery, Faculty of Medicine in Hradec Králové, Charles University in Prague, University Hospital Hradec Králové, Hradec Králové, Czech Republic.
Fingerland Department of Pathology, Faculty of Medicine Hradec Králové, Charles University in Prague, University Hospital Hradec Králové, Hradec Králové, Czech Republic.
Colorectal Dis. 2015 Oct;17(10):876-81. doi: 10.1111/codi.12953.
A study was carried out to determine the relationship between mesorectal lymph nodal involvement and T stage in a group of patients with a rectal cancer involving less than one-quarter of the rectal circumference, such as might be selected for local excision.
The data of patients having rectal resection between 2010 and 2014 were prospectively entered in a rectal carcinoma registry. A model for describing tumours involving less than one quadrant of the rectal circumference was created to facilitate the evaluation process.
In all, 304 patients were included in the study. In 68 (22.4%) a small tumour (< 1 quadrant involved) was found. Of these, 26.5% had positive mesorectal lymph nodes (N+). In lesions of Stage ypT0 cancer 12.5% patients were node positive, in Stage Tis and T1 tumours there was no case of node positivity, but in Stage T2 and Stage T3 cancers the incidence of node positivity was 27.5% and 64%.
The study demonstrated that, even for small tumours involving only one rectal quadrant, the risk of lymph nodal involvement was about 25%. Had the patients undergone local excision the treatment would have been incomplete.
开展一项研究以确定一组直肠癌累及直肠周径不到四分之一（如可能被选作局部切除的病例）患者的直肠系膜淋巴结受累情况与T分期之间的关系。
将2010年至2014年期间接受直肠切除术患者的数据前瞻性地录入直肠癌登记系统。创建了一个用于描述累及直肠周径不到四分之一的肿瘤的模型，以促进评估过程。
该研究共纳入304例患者。其中68例（22.4%）发现为小肿瘤（累及不到一个象限）。在这些患者中，26.5%的直肠系膜淋巴结阳性（N+）。在ypT0期癌症病变中，12.5%的患者淋巴结阳性；在Tis期和T1期肿瘤中，无淋巴结阳性病例，但在T2期和T3期癌症中，淋巴结阳性发生率分别为27.5%和64%。
该研究表明，即使对于仅累及一个直肠象限的小肿瘤，淋巴结受累风险约为25%。若患者接受局部切除，治疗将不完整。
