Weitensfelder W, Trattning J, Redtenbacher M, Pflanzl W
Zentralbl Chir. 1986;111(4):196-206.
A retrospective analysis was made of data pre-operatively obtained from 110 patients who had undergone curative, palliative or exploratory surgery for midrectal carcinoma, between 1972 and 1983. Macroscopic tumour findings obtained from rectoscopy, in that context, were found to provide a clue to loco-regional spread (p = between 0.0001 and 0.0162). On the other hand, no information as to loco-regional spread proved to be recordable by histological typing of mid-rectum carcinomas, but for tubulo-papillary carcinoma (p = 0.0153). Grading could provide a clue as to possible lymph node involvement (p = 0.0205). A clearly differentiated prognosis could be usually made by macroscopic tumour appearance (p = 0.0001 to 0.0657). Histological typing was of no value for prognostication (p larger than 0.337), while the value of grading proved to be extremely low (p = 0.1819). Incidence of locally delimited recurrences could not be safely forecast at all, neither by macroscopic assessment (p larger than 0.119) nor by microscopy (p larger than 0.161). The information obtainable from macroscopic findings on both present phase and prognosis was generally greater than that recorded from histological processing of biopsy material (p = 0.0470) and should, therefore, by no means be neglected in pre-operative reconnaissance.
对1972年至1983年间接受根治性、姑息性或探索性手术治疗的110例中直肠癌患者术前获得的数据进行了回顾性分析。在此背景下，经直肠镜检查获得的宏观肿瘤发现被认为可为局部区域扩散提供线索（p值在0.0001至0.0162之间）。另一方面，除管状乳头状癌外（p = 0.0153），中直肠癌的组织学类型未被证明可记录有关局部区域扩散的信息。分级可为可能的淋巴结受累提供线索（p = 0.0205）。通常可通过宏观肿瘤外观做出明确的预后判断（p值在0.0001至0.0657之间）。组织学类型对预后判断无价值（p值大于0.337），而分级的价值极低（p = 0.1819）。无论是通过宏观评估（p值大于0.119）还是显微镜检查（p值大于0.161），都无法可靠地预测局部局限性复发的发生率。从当前阶段和预后的宏观发现中获得的信息通常比活检材料的组织学处理记录的信息更多（p = 0.0470），因此，在术前评估中绝不应忽视这些信息。
