左右半结肠癌淋巴结转移差异.docVIP

左右半结肠癌淋巴结转移差异 　　【摘要】 目的 探讨左、右半结肠癌淋巴结转移方式上的差异。方法 结肠癌患者118例,其中行 D2 式淋巴廓清术者12例,D3式90例,D4式16例。用新鲜标本挤压触诊法行淋巴结检取。统计 N1,N2,N3,N4 站淋巴结的转移情况。结果左半结肠癌淋巴结转移率为33.8%,其中肠旁淋巴结转移率为28.0%,中枢方向淋巴结转移率为19.1%。右半结肠癌的淋巴结转移率为52.0%,其中肠旁淋巴结转移率为52.0%,中枢方向淋巴结转移率为38.0%。结论 右半结肠癌肠旁淋巴结及中枢方向淋巴结的转移率均高于左半结肠癌。结肠癌的手术应以 D3 术式为基本术式,重点要清扫向中枢方向转移的淋巴结。 　　【关键词】 　　结肠癌;淋巴结转移;D3 手术 　　 　　Difference of the lymph node metastasis between left and right colon cancer YIN Fang,CHEN Kai,LI Huai-fu.Department of General Surgery,the Fifth Affiliated Hospital of Sun Yet-sen University,Zhuhai,Guangdong 519000,China 　　【Abstract】 Objective To explore the differences of left and right colon cancer lymph node metastasis ways.Methods 118 cases of patients with colon cancer,in which line D2-type dissection in 12 cases,D3-type 90 cases,D4-type in 16 cases were studied.Lymph node was examined by fresh specimens’ compression and palpation.Lymph nodes at N1,N2,N3,N4 stations were statistized.Results Left colon cancer lymph node metastasis rate was 33.8%,in which intestinal lymph node metastasis rate was 28.0%,and the central direction of lymph node metastasis rate was 19.1%.Right colon cancer lymph node metastasis rate was 52.0%,in which intestinal lymph node metastasis rate was 52.0%,and the central direction of lymph node metastasis rate was 38.0%.Conclusion The right colon intestinal lymph nodes and the central direction of lymph node metastasis rate are higher than those of the left colon.Colon cancer surgery should be based on D3-type as the basic surgical technique,and we should be focus to clean the central direction of the transfer of lymph node. 　　【Key words】 　　Colon Cancer;Lymphatic metastasis;D3 radical operation 　　 　　目前结直肠癌的发病率在男性位于肺癌、胃癌之后,在女性位于乳腺癌及宫颈癌之后,并呈逐渐上升之势。20世纪70年代中期直肠癌的发病率高于结肠癌,至 90年代后者超过了前者。国外90年代结肠癌与直肠癌的发病率之比已达 3:1,并有近??结肠发病率有增高之势[1]。本研究旨在探讨左、右半结肠癌淋巴结转移之间的差异。 　　1 资料与方法 　　1.1 一般资料 资料选自2006年7月至2009年7月在中山大学附属第五医院手术的原发性结肠癌患者。排除多原发结肠癌、家族性腺瘤性息肉病(FAP)、同时或既往患有其他恶性肿瘤、结肠癌术后复发或转移的患者,共118例患者纳入本组。其中男53例,女65例;年龄21