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在结直肠癌中,对肠切除切缘进行常规检查有何依据?

Is there any justification for the routine examination of bowel resection margins in colorectal adenocarcinoma?

作者信息

Cross S S, Bull A D, Smith J H

机构信息

Department of Histopathology, Northern General Hospital, Sheffield.

出版信息

J Clin Pathol. 1989 Oct;42(10):1040-2. doi: 10.1136/jcp.42.10.1040.

Abstract

The proximal and distal bowel resection margins of 339 specimens of colorectal adenocarcinoma were examined for the presence of tumour. In only five cases was tumour found in a resection margin. In four of these cases macroscopic examination showed that the tumour extended to the resection margin. In the fifth case the tumour was present in the pericolic fat. These results and reported data on the intramural spread of colorectal cancer suggest that examination of bowel resection margins is unnecessary unless the tumour extends to within 2 cm of the resection margin. Examination of the deep radial margins of the tumour and slides to show other prognostic indicators would be a more effective use of histopathological resources.

摘要

对339例结肠直肠癌标本的近端和远端肠切除边缘进行肿瘤检查。仅在5例标本的切除边缘发现肿瘤。其中4例经肉眼检查显示肿瘤延伸至切除边缘。第5例肿瘤存在于结肠周围脂肪中。这些结果以及有关结直肠癌壁内扩散的报告数据表明,除非肿瘤延伸至距切除边缘2厘米以内,否则无需检查肠切除边缘。检查肿瘤的深部径向边缘并制作切片以显示其他预后指标将能更有效地利用组织病理学资源。

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