Naito Atsushi, Iwamoto Kazuya, Ohtsuka Masahisa, Imasato Mitsunobu, Nakahara Yujiro, Mikamori Manabu, Furukawa Kenta, Moon Jeongho, Asaoka Tadafumi, Kishi Kentaro, Akamatsu Hiroki
Department of Surgery, Osaka Police Hospital, Osaka, Japan
Department of Surgery, Osaka Police Hospital, Osaka, Japan.
In Vivo. 2021 Mar-Apr;35(2):987-991. doi: 10.21873/invivo.12341.
BACKGROUND/AIM: The rate of lymph node metastasis (LNM) of colorectal carcinoma (CRC) with a submucosal (SM) invasion depth of 1000 µm or more can reach 12.5%, which is the most common reason for additional resection in daily practice. Other studies have reported that the rate of LNM is less than 2%, regardless of the depth of invasion, if the lesions show good histology, lymphovascular infiltration is negative, and tumor budding is limited. The purpose of this study was to investigate new risk factors for LNM in T1b colorectal cancer.
The 239 patients who were diagnosed with pathological T1b CRC after colorectal surgical resection at the Osaka Police Hospital in Japan between January 2008 and December 2018 were retrospectively reviewed in this study.
The LNM rate was 11.3% (27/239). The variables identified as being significant factors using multivariate analysis were: i) lymphatic invasion (Ly)-positive [odds ratio (OR)=5.97; 95% confidence interval (CI)=2.27-15.74], ii) female gender (OR=3.49; 95%CI=1.38-8.85), and iii) left-sided colorectal involvement (OR=4.98; 95%CI=1.22-20.39). If none of these risk factors were present with T1b, the LNM rate was 0% (0/28).
Ly-positive, female gender, and left-sided colorectal involvement could be risk factors for LNM in T1b CRC.
背景/目的：黏膜下（SM）浸润深度达1000µm或更深的结直肠癌（CRC）的淋巴结转移（LNM）率可达12.5%，这是日常实践中进行额外切除的最常见原因。其他研究报告称，如果病变组织学表现良好、无淋巴管浸润且肿瘤芽生有限，则无论浸润深度如何，LNM率均低于2%。本研究的目的是调查T1b期结直肠癌LNM的新危险因素。
本研究回顾性分析了2008年1月至2018年12月期间在日本大阪警察医院接受结直肠手术切除后被诊断为病理T1b期CRC的239例患者。
LNM率为11.3%（27/239）。多因素分析确定为显著因素的变量有：i）淋巴管浸润（Ly）阳性[比值比（OR）=5.97；95%置信区间（CI）=2.27 - 15.74]，ii）女性（OR=3.49；95%CI=1.38 - 8.85），以及iii）左半结肠受累（OR=4.98；95%CI=1.22 - 20.39）。如果T1b期不存在这些危险因素，则LNM率为0%（0/28）。
Ly阳性、女性以及左半结肠受累可能是T1b期CRC发生LNM的危险因素。
