Ichimasa Katsuro, Kudo Shin-Ei, Miyachi Hideyuki, Kouyama Yuta, Hayashi Takemasa, Wakamura Kunihiko, Hisayuki Tomokazu, Kudo Toyoki, Misawa Masashi, Mori Yuichi, Matsudaira Shingo, Hidaka Eiji, Hamatani Shigeharu, Ishida Fumio
Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama 224-8503, Japan.
Oncol Lett. 2017 Feb;13(2):805-810. doi: 10.3892/ol.2016.5464. Epub 2016 Dec 6.
Lymph node metastasis significantly influences the management of patients with colorectal carcinoma. It has been observed that the biology of colorectal carcinoma differs by location. The aim of the current study was to retrospectively compare the clinicopathological characteristics of patients with colon and rectal T1 carcinomas, particularly their rates of lymph node metastasis. Of the 19,864 patients who underwent endoscopic or surgical resection of colorectal neoplasms at Showa University Northern Yokohama Hospital, 557 had T1 surgically resected carcinomas, including 457 patients with colon T1 carcinomas and 100 patients with rectal T1 carcinomas. Analysed clinicopathological features included patient age, gender, tumor size, morphology, tumor budding, invasion depth, vascular invasion, histological grade, lymphatic invasion and lymph node metastasis. Rectal T1 carcinomas were significantly larger than colon T1 carcinomas (mean ± standard deviation: 23.7±13.1 mm vs. 19.9±11.0 mm, P<0.01) and were accompanied by significantly higher rates of vascular invasion (48.0% vs. 30.2%, P<0.01). Significant differences were not observed among any other clinicopathological factors. In conclusion, tumor location itself was not a risk factor for lymph node metastasis in colorectal T1 carcinomas, even though on average, rectal T1 carcinomas were larger and accompanied by a significantly higher rate of vascular invasion than colon T1 carcinomas.
淋巴结转移显著影响结直肠癌患者的治疗。据观察，结直肠癌的生物学特性因部位而异。本研究的目的是回顾性比较结肠和直肠T1期癌患者的临床病理特征，尤其是它们的淋巴结转移率。在昭和大学北横滨医院接受结直肠肿瘤内镜或手术切除的19864例患者中，557例接受了T1期癌手术切除，其中包括457例结肠T1期癌患者和100例直肠T1期癌患者。分析的临床病理特征包括患者年龄、性别、肿瘤大小、形态、肿瘤芽生、浸润深度、血管侵犯、组织学分级、淋巴侵犯和淋巴结转移。直肠T1期癌明显大于结肠T1期癌（平均值±标准差：23.7±13.1mm对19.9±11.0mm，P<0.01），且血管侵犯率明显更高（48.0%对30.2%，P<0.01）。在任何其他临床病理因素之间未观察到显著差异。总之，肿瘤部位本身不是结直肠T1期癌淋巴结转移的危险因素，尽管平均而言，直肠T1期癌比结肠T1期癌更大，且血管侵犯率明显更高。
