Nanko M, Shimada H, Yamaoka H, Tanaka K, Masui H, Matsuo K, Ike H, Oki S, Hara M
Second Department of Surgery, Yokohama City University, School of Medicine, Japan.
Surg Today. 1998;28(7):707-13. doi: 10.1007/BF02484616.
A surgical resection of metastatic liver lesions from colorectal cancer contributes to an improved prognosis. However, the postoperative recurrence rate remains high, particularly in the residual liver. This is probably the result of the failure to detect small lesions. In the present study, we histologically examined the presence of intrahepatic micrometastases, which are considered to be related to recurrence in the residual liver. Intrahepatic micrometastases were histologically examined in 31 resected specimens of 25 patients undergoing a hepatic resection because of metastasis to the liver from colorectal cancer. Micrometastases were found in 14 of 25 cases (56.0%). They were located in the portal veins, central veins, sinusoid, and bile ducts. The longest distance from the main metastasis was 38.2 (mean 7.5 +/- 8.0) mm. The size of the macrometastases became larger, and the frequency of micrometastases and the distance of micrometastases from macrometastases had a tendency to increase. Continuous invasion of the macrometastases into the micrometastases through the vasculature or bile duct was also observed. These results suggested that some micrometastases observed in the metastatic liver from colorectal cancer were thus seeded from the primary lesions, while other micrometastases originated from the macrometastatic lesions as satellite lesions.
结直肠癌肝转移灶的手术切除有助于改善预后。然而，术后复发率仍然很高，尤其是在残余肝脏中。这可能是未能检测到小病灶的结果。在本研究中，我们对肝内微转移灶的存在进行了组织学检查，这些微转移灶被认为与残余肝脏的复发有关。对25例因结直肠癌肝转移而接受肝切除的患者的31个切除标本进行了肝内微转移灶的组织学检查。25例中有14例（56.0%）发现微转移灶。它们位于门静脉、中央静脉、肝血窦和胆管。距主要转移灶的最长距离为38.2（平均7.5±8.0）mm。大转移灶的大小变大，微转移灶的频率以及微转移灶与大转移灶的距离有增加的趋势。还观察到通过脉管系统或胆管大转移灶向微转移灶的连续侵袭。这些结果表明，在结直肠癌肝转移中观察到的一些微转移灶是由原发灶播散而来，而其他微转移灶则作为卫星灶起源于大转移灶。
