大组织切片技术对直肠癌淋巴结转移探究.doc

大组织切片技术对直肠癌淋巴结转移探究[摘要] 目的 利用大组织切片技术对直肠癌淋巴结转移的情况进行观察,并分析与临床病理特征的关系。方法 将2005年6月～2008年12月的148例行全直肠系膜切除术的直肠癌患者随机分为两组,试验组76例采用大组织切片技术,对照组72例采用传统病理技术,对比研究淋巴结转移情况,并对影响淋巴结转移的临床病理因素进行分析。结果 试验组平均检出淋巴结(16.8±3.9)枚,阳性淋巴结(2.3±3.6)枚,对照组平均检出淋巴结(10.7±2.1)枚,阳性淋巴结(1.1±2.1)枚,差异均存在在统计学意义(t=11.932,P=0.000;t=2.339,P=0.021)。有淋巴结转移的病例淋巴结检出个数与无淋巴结转移的病例淋巴结检出个数试验组差异无统计学意义(t=1.049,P=0.298),对照组差异存在统计学意义(t=5.762,P=0.000)。不同大体分型、肿瘤直径、累及肠壁周径程度、T分期、分化程度的肿瘤淋巴结转移率不同(χ2=12.979,P=0.002;χ2=5.543,P=0.020;χ2=8.096,P=0.044;χ2=11.478,P=0.006;χ2=9.377,P=0.009)。结论 大组织切片技术能较好的研究直肠癌淋巴结转移情况,直肠癌淋巴结转移与大体分型、肿瘤直径、累及肠壁周径程度、T分期及分化程度存在相关。 [关键词] 直肠肿瘤; 淋巴转移; 病理学 [中图分类号] R735.37 [文献标识码] A [文章编号] 1673-9701(2009)33-03-03 Large Slice Technique for Lymph Node Metastasis ofRectal Cancer YU Hongwei1 JIANG Nan2 LIU Jinhong3 1.Department of General Surgery,the Affiliated Hospital of Mudanjiang Medical College,Mudanjiang 157001,China;2.Department of General Surgery,the First Affiliated Hospital of Tsinghua University,Beijing 100016,China;3.Department of Pathology,the First Affiliated Hospital of Tsinghua University,Beijing 100016,China [Abstract] ObjectiveTo investigate the mesorectal lymph node metastasis of rectal cancer by the large slice technique and to identify the correlation of the metastasis with clinicopathological characteristics. MethodsFrom June 2005 to Nov 2008,148 patients with rectal cancer who underwent total mesorectal excision were randomly divided into two groups,trail group(n=76) and control group(n=72). The trail group was examined by the large slice technique,the control group was examined by the traditional pathological methods,and lymph nodes metastasis was compared between two groups. Possible influencing clinicopathological factors were also analyzed. ResultsThe number of the lymph nodes detected from the trail group was 16.8±3.9 and that of the positive lymph nodes was(2.3±3.6),while the number of the lymph nodes of the control group was(10.7±2.1) and that of the positive nodes was(1.1±