Shirouzu K, Isomoto H, Morodomi T, Kakegawa T
First Department of Surgery, Kurume University School of Medicine, Japan.
Cancer. 1995 Jan 1;75(1):4-10. doi: 10.1002/1097-0142(19950101)75:1<4::aid-cncr2820750103>3.0.co;2-q.
The question of whether lymphatic permeation in rectal carcinoma is an index of prognosis remains controversial.
A long term prospective study of lymphatic permeation of 288 rectal carcinomas was performed. The degree of lymphatic permeation was divided into four stages (Ly0 through Ly3). The median follow-up for the surviving patients was 84 months (range, 23 to 151 months).
In patients with UICC Stage I or II disease, there was no correlation between the Ly0 and Ly1-3 groups' recurrence or survival rates. In patients with Stage IIIa disease, the rate of postoperative recurrence was significantly higher in the Ly1 or Ly2 + Ly3 groups compared with the Ly0 group. The 10-year survival and disease free survival rates in patients with Stage IIIa disease were both 90.0% in the Ly0 group, 63.6% and 62.5% in the Ly1 group, and 52.0% and 45.5% in the Ly2 + Ly3 groups, respectively. A significant difference was noted in the survival rates between the Ly0 and Ly2 + Ly3 groups (P < 0.05), and was noted in the disease free survival rates between the Ly0 and Ly1 (or Ly2 + Ly3) groups (P < 0.05, P < 0.005). In patients with Stage IIIb disease, there were trends toward higher recurrence, lower survival, or disease free survival rates in the Ly2 + Ly3 groups compared with the Ly1 group (P < 0.1).
The degree of lymphatic permeation is an important prognostic factor in patients with Stage III disease, especially in those with Stage IIIa disease. It should be classified as a clinical subgroup.
直肠癌中淋巴管浸润是否为预后指标的问题仍存在争议。
对288例直肠癌的淋巴管浸润进行了长期前瞻性研究。淋巴管浸润程度分为四个阶段（Ly0至Ly3）。存活患者的中位随访时间为84个月（范围23至151个月）。
在国际抗癌联盟（UICC）I期或II期疾病患者中，Ly0组与Ly1 - 3组的复发率或生存率之间无相关性。在IIIa期疾病患者中，Ly1组或Ly2 + Ly3组的术后复发率显著高于Ly0组。IIIa期疾病患者中，Ly0组的10年生存率和无病生存率均为90.0%，Ly1组分别为63.6%和62.5%，Ly2 + Ly3组分别为52.0%和45.5%。Ly0组与Ly2 + Ly3组之间的生存率有显著差异（P < 0.05），Ly0组与Ly1（或Ly2 + Ly3）组之间的无病生存率有显著差异（P < 0.05，P < 0.005）。在IIIb期疾病患者中，Ly2 + Ly3组与Ly1组相比，复发率更高、生存率或无病生存率更低的趋势（P < 0.1）。
淋巴管浸润程度是III期疾病患者，尤其是IIIa期疾病患者的重要预后因素。应将其归类为一个临床亚组。
