目的　通过临床病理学研究 ,证实直肠癌扩大根治术的合理性 ,从而指导直肠癌的治疗。方法　对进展期直肠癌进行三方向淋巴结清扫 ,以常规病理学方法研究淋巴转移规律 ,并以此规律指导临床进行扩大根治手术 ,统计分析其治疗效果。结果　中国人进展期直肠癌淋巴转移率为45 .0 % ,转移度为 7.5 % ,上方第 1,2 ,3站转移率分别为 44 .0 %、14.0 %和 10 .0 % ,侧方第 3站转移率为 9.0 %。直肠癌淋巴转移与肿瘤侵袭周径、深度及病理学类型有关。扩大根治术后的 5 ,10年生存率分别为 6 8.0 %和 47.0 % ,高于一般根治术的 45 .0 %和 39.8%。侧方转移者的 5年生存率达 48.1%。结论　直肠癌扩大根治术清除了可能发生转移的全部淋巴结 ,减少了转移淋巴结残留 ,可明显提高生存率 ,是比较理想的手术方式。 Objective To confirm the rationality of extended radical resection for rectal cancer through clinical pathology studies, and to guide the treatment of rectal cancer. Methods Three-way lymph node dissection was performed on advanced rectal cancer. The regularity of lymphatic metastasis was studied by routine pathological methods, and the rule was used to guide clinical expansion of radical surgery. The therapeutic effect was analyzed statistically. Results The lymphatic metastasis rate of advanced colorectal cancer in China was 45.0 %, the degree of metastasis was 7.5 %, and the metastatic rates at the 1st, 2 nd and 3 rd stations above were 44.0%, 14.0% and 10.0%, respectively. The transfer rate of 3 stations is 9.0%. Lymphatic metastasis of rectal cancer is related to the diameter, depth and pathological type of tumor invasion. The 5-year and 10-year survival rates after extensive radical resection were 68.0% and 47.0%, respectively, which was higher than the 45.0% and 39.8% of the general radical mastectomy. The 5-year survival rate of the side-shifters reached 48.1%. Conclusion Extended radical resection of rectal cancer removes all lymph nodes that may metastasize, reduces the residual lymph node metastasis, and can significantly improve the survival rate. It is an ideal surgical method.