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目的 探讨结直肠癌淋巴结转移的相关因素。方法 收集南方医院 1975～ 1999年间手术治疗的结直肠癌 1374例 ,建立全部资料的Access数据库 ,选择相关的字段进行检索 ,从不同角度分析各临床及病理因素与淋巴结转移的关系。结果 30岁以下年龄组的淋巴结转移率为 5 1 9% ,5 1岁以上年龄组的淋巴结转移率为 31 3%。随着肿瘤浸润深度的增加 ,其淋巴结转移率增高。随肠管受肿瘤侵犯的周径增大 ,淋巴结转移可能性增大。隆起型肿瘤的淋巴结转移率为 30 9% ,溃疡型为 39 7% ,浸润型为 42 1% ,胶样型为 42 9%。腺癌、黏液腺癌、印戒细胞癌的转移率分别为 33 3%、49 6 %和 6 1 1% ,且随肿瘤的分化程度降低 ,淋巴结转移率增高。肿瘤体积的大小及术前癌胚抗原 (CEA)水平与淋巴结转移无关。结论 结直肠癌的淋巴结转移与多种因素有关 ,这些因素主要有 :年龄、肿物侵犯肠管周径、大体类型、病理类型、分化程度、生长方式、浸润深度。肿物体积的大小与淋巴结转移无关。这些因素之间是互相联系、互相影响的。
Objective To investigate the related factors of lymph node metastasis in colorectal cancer. Methods A total of 1374 colorectal cancers were surgically treated in Southern Hospital from 1975 to 1999. The Access database was established for all data and related fields were selected for searching. The relationship between clinical and pathological factors and lymph node metastasis was analyzed from different perspectives. Results The lymph node metastasis rate in the 30-year-old group was 519%, and the lymph node metastasis rate in the 51+-year-old group was 31 3%. As the depth of tumor invasion increased, the lymph node metastasis rate increased. With the increase of the diameter of the bowel tumor invasion, the possibility of lymph node metastasis increased. The lymph node metastasis rate was 30.9% for ulcerative tumors, 39.7% for ulcers, 42.1% for infiltrates, and 42.9% for gels. The metastatic rates of adenocarcinoma, mucinous adenocarcinoma, and signet ring cell carcinoma were 33 3%, 49.6%, and 61.1%, respectively, and the rate of lymph node metastasis increased with the degree of tumor differentiation. The size of the tumor volume and preoperative carcinoembryonic antigen (CEA) levels were not associated with lymph node metastasis. Conclusion The lymph node metastasis of colorectal cancer is related to many factors, such as age, tumor invasion, intestinal diameter, gross type, pathological type, differentiation degree, growth pattern, depth of invasion. The size of the tumor volume has nothing to do with lymph node metastasis. These factors are interrelated and affect each other.