T2期结直肠癌的淋巴结转移危险因素
Lymph node metastasis risk factors in T2 colorectal cancer.
作者信息
Morita Yuriko, Kudo Shin-Ei, Takashina Yuki, Ichimasa Katsuro, Kouyama Yuta, Semba Shigenori, Mochizuki Kenichi, Shiina Osamu, Kato Shun, Kuroki Takanori, Shimada Shoji, Nakahara Kenta, Takehara Yusuke, Mukai Shunpei, Ogata Noriyuki, Hayashi Takemasa, Wakamura Kunihiko, Miyachi Hideyuki, Sawada Naruhiko, Nemoto Tetsuo, Baba Toshiyuki, Misawa Masashi
机构信息
Digestive Disease Center Showa University Northern Yokohama Hospital Kanagawa Japan.
Department of Medicine National University of Singapore Singapore Singapore.
出版信息
DEN Open. 2024 Nov 29;5(1):e70040. doi: 10.1002/deo2.70040. eCollection 2025 Apr.
OBJECTIVES
This study evaluates risk factors for lymph node metastasis (LNM) in T2 colorectal cancer to refine patient selection for endoscopic resection.
METHODS
We reviewed records from consecutive patients who had undergone curative surgical resection of T2 colorectal cancer at our institution in Japan between April 2001 and December 2021. Data on conventional clinicopathologic variables were retrieved from the pathology reports at the time of surgery. The clinicopathological features included patient age, sex, tumor diameter, morphology, tumor location, lymphatic invasion, vascular invasion, tumor differentiation, carcinoembryonic antigen and carbohydrate antigen 19-9 levels, number of lymph node dissections, presence of adenoma component, and LNM.
RESULTS
Among the patients (338 men, 320 women), 170 (25.8%) exhibited LNM. Multivariate logistic regression identified three independent risk factors for LNM: lymphatic invasion (odds ratio [OR], 32.6; 95% confidence interval [CI], 17.3-61.4; < 0.0001), female sex (OR, 1.70; 95% CI, 1.10-2.62; = 0.02), and elevated carcinoembryonic antigen levels (OR, 2.56; 95% CI, 1.10-5.96; = 0.03).
CONCLUSIONS
Lymphatic invasion, female sex, and high carcinoembryonic antigen levels significantly increase the risk of LNM in T2 colorectal cancer.
目的
本研究评估T2期结直肠癌淋巴结转移（LNM）的危险因素，以优化内镜切除的患者选择。
方法
我们回顾了2001年4月至2021年12月期间在日本我们机构接受T2期结直肠癌根治性手术切除的连续患者的记录。手术时从病理报告中获取常规临床病理变量的数据。临床病理特征包括患者年龄、性别、肿瘤直径、形态、肿瘤位置、淋巴侵犯、血管侵犯、肿瘤分化、癌胚抗原和糖类抗原19-9水平、淋巴结清扫数量、腺瘤成分的存在以及LNM。
结果
在这些患者中（338名男性，320名女性），170名（25.8%）出现LNM。多因素逻辑回归确定了LNM的三个独立危险因素：淋巴侵犯（比值比[OR]，32.6；95%置信区间[CI]，17.3 - 61.4；<0.0001）、女性（OR，1.70；95% CI，1.10 - 2.62；=0.02）和癌胚抗原水平升高（OR，2.56；95% CI，1.10 - 5.96；=0.03）。
结论
淋巴侵犯、女性和高癌胚抗原水平显著增加T2期结直肠癌发生LNM的风险。
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