[形态学研究对于精确确定直肠癌局部扩散范围的重要性]

[Importance of morphological studies for precise determination of the limits of local spread of rectal cancer].

作者信息

Protchenko N V, Rottenberg V I

出版信息

Vestn Khir Im I I Grek. 1977 Mar;118(3):69-72.

Abstract

115 samples of the rectum were investigated after radical operation for its cancer. In 61 samples its intramural distribution was studied by means of transverse section of the rectum distally to tumor as well as the involvement of regional lymph nodes, cellular tissue and sphincter muscles. The preferential direction of tumor invasion in different stages of cancer growth is a "perpendicular" tumor growth. In 6 samples the spread of distal intramural growth exceeds 2 cm and in 1 sample -- 6cm. No sphincter involvement was noted. Regional metastases were found in 37 per cent of observations. Retrograde metastases were detected in 3 samples. In 7 of 15 samples with total proliferation of the rectal wall tumor elements were detected in peripheral cellular tissue "perpendicularly" above the tumor. The problem of the adequate extent of the operation should be solved taking into account the tumor site, histological structure, limits of intramural and extramural growth and tumor size.

摘要

对115例直肠癌根治术后的直肠标本进行了研究。在61例标本中，通过在肿瘤远端对直肠进行横切，研究了肿瘤的壁内分布以及区域淋巴结、细胞组织和括约肌的受累情况。在癌症生长的不同阶段，肿瘤侵袭的优先方向是“垂直”生长。在6例标本中，远端壁内生长的范围超过2厘米，1例超过6厘米。未发现括约肌受累。在37%的观察病例中发现了区域转移。在3例标本中检测到逆行转移。在15例直肠壁完全增生的标本中，有7例在肿瘤上方的外周细胞组织中“垂直”检测到肿瘤成分。应根据肿瘤部位、组织结构、壁内和壁外生长范围以及肿瘤大小来解决手术切除范围是否足够的问题。