Analysis of Lymph Node Metastasis and Clinical Characteristic in Rectal Cancer (Report of 79Cases )_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Defu , ZHANG Min.

Department of General Surgery, The Second People’s Hospital of Meishan City, Meishan 620010, Sichuan Province, ChinaCorresponding Author: LI De-fu, E-mail: shanghailaojia@yahoo.com.cn;

Corresponding author：

Keywords：

Rectal cancer; Lymph node metastasis

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Objective 　To investigate the correlation among lymph node metastasis and clinical features, postoperative survival rate in rectal cancer.
Methods 　Seventy-nine patients who had accepted total mesorectal excision (TME) were collected, and the correlation among their clinical features (including gender, age, tumor size, gross type, depth of infiltration, histology type, differentiated degree and the level of blood serum CEA), lymph node metastasis, and postoperative survival rate were analyzed.
Results 　There was significant correlation between six factors (namely the tumor size, gross type, depth of infiltration, histology type, differentiated degree and the level of blood serum CEA) and lymph node metastasis in single factor analysis. However， multivariate analysis showed that only gross type of tumor and depth of tumor infiltration were related to lymph node metastasis. The postoperative survival time of 43 non-metastasis cases was remarkably longer than that of 33 cases with lymph node metastasis (χ2=18.806， P=0.000), and it was longer in 22 cases with ＜4 lymph nodes metastasis than that of 11 cases with ≥4 lymph nodes metastasis (χ2=4.659， P=0.031).
Conclusion 　In rectal cancer patients the clinical features can reflect the condition of lymph node metastasis in a certain extent, and it can help doctors to evaluate the lymph node metastasis and prognosis.

Citation： LI Defu,ZHANG Min.. Analysis of Lymph Node Metastasis and Clinical Characteristic in Rectal Cancer (Report of 79Cases ). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(9): 652-655. doi: Copy

1.	赵文军, 张才全, 王青, 等. 直肠癌远端肠壁浸润的研究 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(1)∶94.
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12.	屠世良, 叶再元, 邓高里, 等. 直肠癌患者淋巴结转移的相关因素分析 [Ｊ]. 浙江医学, 2008; 30(2)∶123.
13.	李坚, 罗大辉, 李立新. 直肠癌淋巴结转移分析 [Ｊ]. 中国医药导报, 2007; 4(34)∶104.
14.	殷志韬, 孙纪元, 吴广威, 等. 直肠癌淋巴结转移影响因素的临床研究 [Ｊ]. 中国实用外科杂志, 2004; 24(3)∶1161.
15.	汪建平, 杨祖立, 王磊, 等. 结直肠癌临床病理特征与预后的多因素回归分析 [Ｊ]. 中华肿瘤杂志, 2003; 25(1)∶59.
16.	Heald RJ, Moran BJ, Ryall RD, et al. Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978-1997 [Ｊ]. Arch Surg, 1998; 133(8)∶894.
17.	Roncucci L, Fante R, Losi L, et al. Survival for colon and rectal cancer in a population-based cancer registry [Ｊ]. Eur J Cancer, 1996; 32A(2)∶295.
18.	Elsaleh H, Cserni G, Iacopetta B. Extent of nodal involvement in stage Ⅲ colorectal carcinoma: relationship to clinicopathologic variables and genetic alterations [Ｊ]. Dis Colon Rectum, 2002; 45(9)∶1218.
19.	郑阳春, 周总光. 结直肠癌前哨淋巴结活检的研究进展 [Ｊ]. 中国普外基础与临床杂志， 2004; 11(4)∶130.
20.	Cohen AM, Kelsen D, Saltz L, et al. Adjuvant therapy for colorectal cancer [Ｊ]. Curr Probl Surg, 1997; 34(8)∶601.
21.	Hida J, Yasutomi M, Maruyama T, et al. Indication for using high ligation of the inferior mesenteric artery in rectal cancer surgery. Examination of nodal metastases by the clearing method [Ｊ].Dis Colon Rectum， 1998; 41(8)∶984.

1. 　赵文军, 张才全, 王青, 等. 直肠癌远端肠壁浸润的研究 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(1)∶94.
2. 　乔唐, 柏斗胜, 徐永建, 等. 低位直肠癌的保肛手术(附90 例报告) [Ｊ]. 中国普外基础与临床杂志, 2005; 12(5)∶516.
3. 　 Harris GJ, Church JM, Senagore AJ, et al. Factors affecting local recurrence of colonic adenocarcinoma [Ｊ]. Dis Colon Rectum, 2002; 45(8)∶1029.
4. 　 Kanemitsu Y, Kato T, Hirai T, et al. Survival after curative resection for mucinous adenocarcinoma of the colorectum [Ｊ]. Dis Colon Rectum, 2003; 46(2)∶160.
5. 　Stocchi L, Nelson H, Sargent DJ, et al. Impact of surgical and pathologic variables in rectal cancer: a United States community and cooperative group report [Ｊ]. J Clin Oncol, 2001; 19(18)∶3895.
6. 　Ishikawa Y, Akishima-Fukasawa Y, Ito K, et al. Histopathologic determinants of regional lymph node metastasis in early colorectal cancer [Ｊ]. Cancer, 2008; 112(4)∶924.
7. 　 Suzuki T, Sadahiro S, Mukoyama S, et al. Risk of lymph node and distant metastases in patients with early invasive colorectal cancer classified as Haggitt’s level 4 invasion: image analysis of submucosal layer invasion [Ｊ]. Dis Colon Rectum, 2003; 46(2)∶203.
8. 　Iwashita A. Pathomorphologic study concerning risk factor of lymph node metastasis in colorectal submucosal invasive (sm) carcinomas of Is type [Ｊ]. Stomach & Intestine (Tokyo), 1997; 32(11)∶1511.
9. 　Bayar S, Saxena R, Emir B, et al. Venous invasion may predict lymph node metastasis in early rectal cancer [Ｊ]. Eur J Surg Oncol, 2002; 28(4)∶413.
10. 　Kobayashi M, Watanabe H, Maeo S, et al. Correlation of histological atypia and cancer-sprouting with vascular permeation and lymph nodal metastasis by our new histological classification of submucosal invasion by colorectal carcinomas [Ｊ]. Stomach & Intestine, 1994; 29(11)∶1151.
11. 　Yasuda K, Inomata M, Shiromizu A, et al. Risk factors for occult lymph node metastasis of colorectal cancer invading the submucosa and indications for endoscopic mucosal resection [Ｊ]. Dis Colon Rectum, 2007; 50(9)∶1370.
12. 　屠世良, 叶再元, 邓高里, 等. 直肠癌患者淋巴结转移的相关因素分析 [Ｊ]. 浙江医学, 2008; 30(2)∶123.
13. 　李坚, 罗大辉, 李立新. 直肠癌淋巴结转移分析 [Ｊ]. 中国医药导报, 2007; 4(34)∶104.
14. 　殷志韬, 孙纪元, 吴广威, 等. 直肠癌淋巴结转移影响因素的临床研究 [Ｊ]. 中国实用外科杂志, 2004; 24(3)∶1161.
15. 　汪建平, 杨祖立, 王磊, 等. 结直肠癌临床病理特征与预后的多因素回归分析 [Ｊ]. 中华肿瘤杂志, 2003; 25(1)∶59.
16. 　Heald RJ, Moran BJ, Ryall RD, et al. Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978-1997 [Ｊ]. Arch Surg, 1998; 133(8)∶894.
17. 　Roncucci L, Fante R, Losi L, et al. Survival for colon and rectal cancer in a population-based cancer registry [Ｊ]. Eur J Cancer, 1996; 32A(2)∶295.
18. 　Elsaleh H, Cserni G, Iacopetta B. Extent of nodal involvement in stage Ⅲ colorectal carcinoma: relationship to clinicopathologic variables and genetic alterations [Ｊ]. Dis Colon Rectum, 2002; 45(9)∶1218.
19. 　郑阳春, 周总光. 结直肠癌前哨淋巴结活检的研究进展 [Ｊ]. 中国普外基础与临床杂志， 2004; 11(4)∶130.
20. 　 Cohen AM, Kelsen D, Saltz L, et al. Adjuvant therapy for colorectal cancer [Ｊ]. Curr Probl Surg, 1997; 34(8)∶601.
21. 　Hida J, Yasutomi M, Maruyama T, et al. Indication for using high ligation of the inferior mesenteric artery in rectal cancer surgery. Examination of nodal metastases by the clearing method [Ｊ].Dis Colon Rectum， 1998; 41(8)∶984.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Lymph Node Metastasis and Clinical Characteristic in Rectal Cancer (Report of 79Cases )

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