Zaręba Konrad P, Zińczuk Justyna, Dawidziuk Tomasz, Rosołowski Mariusz, Pryczynicz Anna, Guzińska-Ustymowicz Katarzyna, Kędra Bogusław
2nd Department of General and Gastroenterological Surgery, Medical University of Bialystok, Bialystok, Poland.
Department of Clinical Laboratory Diagnostic, Medical University of Bialystok, Bialystok, Poland.
Prz Gastroenterol. 2020;15(3):247-252. doi: 10.5114/pg.2020.98542. Epub 2020 Sep 19.
As one of the most common causes of cancer deaths in Poland, colorectal cancer, remains a mystery when factors affecting local and distant lymph node metastasis are concerned.
In this study the authors have analysed possible correlations between the number of regional (and distant) lymph nodes affected by cancer, location and stage of the primary tumour, levels of oncological markers CA19-9 and CEA, and the patients age, sex, body mass index (BMI), and other clinical symptoms.
A special questionnaire was created for this study, and a group of 100 men and women was selected. All patients in the study group had undergone surgery due to colorectal cancer.
There were no statistically significant relationships between age, and number and location of metastases ( > 0.05). Primary tumour assessment did not show a statistically significant relationship with the presence of metastases to regional lymph nodes ( > 0.05). There was also no statistically significant correlation between tumour localisation and lymph node metastases ( > 0.05) or between tumour size, BMI, occurrence of physical symptoms, and involvement of distant lymph nodes ( > 0.05). The highest CEA was observed in a patient with nine regional lymph node metastases (612.46 ng/ml) and the lowest in one with metastases to two regional nodes (0.2 U/ml). CEA value above 5 ng/ml was found in 35.74% of patients with regional lymph node metastases. A statistically significant relationship was reported ( < 0.05).
The location of the primary tumour, and its pathological stage and size does not seem to have a direct correlation with the occurrence of regional lymph node metastases. Metastasis to distant lymph nodes seems to be a consequence of metastases in regional nodes. Elevated CEA tumour marker values are significantly related to metastases in regional lymph nodes. The elevation of CA 19-9 and CEA tumour markers significantly correlates with the presence of metastasis to distant lymph nodes. The location of the primary tumour determines the formation of metastases in distant lymph nodes.
作为波兰癌症死亡的最常见原因之一，结直肠癌在影响局部和远处淋巴结转移的因素方面仍是一个谜。
在本研究中，作者分析了受癌症影响的区域（和远处）淋巴结数量、原发性肿瘤的位置和分期、肿瘤标志物CA19-9和CEA水平与患者年龄、性别、体重指数（BMI）及其他临床症状之间可能存在的相关性。
为本研究设计了一份特殊问卷，并选取了100名男性和女性。研究组的所有患者均因结直肠癌接受了手术。
年龄与转移灶数量及位置之间无统计学显著关系（>0.05）。原发性肿瘤评估与区域淋巴结转移的存在无统计学显著关系（>0.05）。肿瘤定位与淋巴结转移之间也无统计学显著相关性（>0.05），肿瘤大小、BMI、身体症状的出现与远处淋巴结受累之间亦无统计学显著相关性（>0.05）。在一名有9个区域淋巴结转移的患者中观察到最高的CEA值（612.46 ng/ml），在一名有2个区域淋巴结转移的患者中观察到最低值（0.2 U/ml）。在35.74%的区域淋巴结转移患者中发现CEA值高于5 ng/ml。报告了统计学显著关系（<0.05）。
原发性肿瘤的位置及其病理分期和大小似乎与区域淋巴结转移的发生无直接相关性。远处淋巴结转移似乎是区域淋巴结转移的结果。CEA肿瘤标志物值升高与区域淋巴结转移显著相关。CA 19-9和CEA肿瘤标志物升高与远处淋巴结转移的存在显著相关。原发性肿瘤的位置决定了远处淋巴结转移的形成。
