摘要
目的探讨中低位直肠癌患者第253组淋巴结转移特点及其影响因素。方法采用回顾性病例对照研究方法。收集2013年1月至2021年10月南京医科大学第一附属医院收治的2316例中低位直肠癌患者的临床病理资料;男1339例,女977例;年龄为(61±12)岁。所有患者行直肠癌D3根治术。观察指标:(1)中低位直肠癌患者第253组淋巴结转移情况。(2)中低位直肠癌患者第253组淋巴结转移的影响因素分析。正态分布的计量资料以x±s表示。计数资料以绝对数和百分比表示,组间比较采用χ^(2)检验。多因素分析采用Logistic回归模型。结果(1)中低位直肠癌患者第253组淋巴结转移情况。2316例患者中,128例第253组淋巴结阳性,2188例第253组淋巴结阴性,淋巴结转移率为5.527%(128/2316)。2316例患者中,肿瘤下缘距肛缘距离为8~10 cm、≥6 cm且<8 cm、<6 cm的例数分别为568例、766例、982例。568例肿瘤下缘距肛缘距离为8~10 cm的直肠癌患者中,57例第253组淋巴结阳性,其中肿瘤分化程度为高、中、低分化患者分别为3例(5.263%)、9例(15.789%)、45例(78.948%);肿瘤TNM分期为Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期患者分别为0例、0例、20例(35.088%)、37例(64.912%)。766例肿瘤下缘距肛缘距离为≥6 cm且<8 cm的直肠癌患者中,42例第253组淋巴结阳性,其中肿瘤分化程度为高、中、低分化患者分别为4例(9.524%)、11例(26.190%)、27例(64.286%);肿瘤TNM分期为Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期患者分别为0例、0例、19例(45.238%)、23例(54.762%)。982例肿瘤下缘距肛缘距离<6 cm的直肠癌患者中,29例第253组淋巴结阳性,其中肿瘤分化程度为高、中、低分化患者分别为1例(3.448%)、3例(10.345%)、25例(86.207%);肿瘤TNM分期为Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期患者分别为0例、0例、12例(41.379%)、17例(58.621%)。(2)中低位直肠癌患者第253组淋巴结转移的影响因素分析。单因素分析结果显示:肿瘤T分期,肿�
Objective To investigate the characteristics of No.253 lymph node metastasis in middle and low rectal cancer and its influencing factors.Methods The retrospective case-control study was conducted.The clinicopathological data of 2316 patients with middle and low rectal cancer who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2013 to October 2021 were collected.There were 1339 males and 977 females,aged(61±12)years.All patients underwent D3 radical surgery for rectal cancer.Observation indicators:(1)No.253 lymph node metastasis in patients with middle and low rectal cancer;(2)analysis of influencing factors for No.253 lymph node metastasis in patients with middle and low rectal cancer.Measurement data with normal distribution were represented as Mean±SD.Count data were expressed as absolute numbers and percentages,and comparison between groups was performed by the chi-square test.Logistic regression model was used for multivariate analysis.Results(1)No.253 lymph node metastasis in patients with middle and low rectal cancer.There were 128 of 2316 patients with positive No.253 lymph node and 2188 cases with negative No.253 lymph node.The No.253 lymph node metastasis rate was 5.527%(128/2316).There were 568 of 2316 patients with the distance from distal margin of tumor to anal margin as 8-10 cm,766 cases as≥6 cm and<8 cm,982 cases as<6 cm.Of the 568 patients with the distance from distal margin of tumor to anal margin as 8-10 cm,57 cases had positive No.253 lymph node,including 3 cases(5.263%)of high differentiated tumor,9 cases(15.789%)of moderate differentiated tumor,45 cases(78.948%)of low differentiated tumor,respectively.There was 0 case of the above 57 patients with positive No.253 lymph node in TNM stageⅠ,0 case in TNM stageⅡ,20 cases(35.088%)in TNM stageⅢ,37 cases(64.912%)in TNM stageⅣ,respectively.Of the 766 patients with the distance from distal margin of tumor to anal margin as≥6 cm and<8 cm,42 cases had positive No.253 lymph node,including 4 cases(9
作者
唐俊伟
王晓伟
李扬
孙跃明
Tang Junwei;Wang Xiaowei;Li Yang;Sun Yueming(Department of Colorectal Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Pathology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2022年第6期773-778,共6页
Chinese Journal of Digestive Surgery
基金
国家重点研发计划(2017YFC0908200)
江苏省重点研发计划(BE2021742)
江苏省基础研究面上项目(BK20201491)
江苏省重点医学学科(普外外科学)(ZDXKA2016005)。
关键词
直肠肿瘤
第253组淋巴结
肠系膜下血管
部位
淋巴结转移
治疗结果
疗效
预后
Rectal neoplasms
No.253 lymph nodes
Submesenteric vessels
Location
Lymph node metastasis
Treatment outcomes
Efficacy
Prognosis
