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目的:探讨结肠脾曲远端结直肠癌中枢方向D3术式的必要性。方法:对2007-2008年收治的39例结肠脾曲远瑞结直肠癌患者中枢方向淋巴结转移及CK20免疫组化淋巴结微转移状况及生存等因素进行分析。结果:10.26%(4/39)的患者发生了N3站淋巴结转移;17.95%(7/39)的患者发生了N3站淋巴结微转移;肿瘤浸润肠腔>1/3周、合并原发灶外癌结节、Dukes分期越高的患者易于出现高站别淋巴结微转移,发生高站别淋巴结微转移的患者预后不良。结论:CK20免疫组化淋巴结微转移检测简便、易行,优于HE染色;结直肠癌中枢方向行D3术式有临床意义。
Objective: To explore the necessity of the D3 procedure for the distal direction of colon and splenic flexure colorectal cancer. Methods: Thirty-nine cases of colonic spleen Qu Yuan-Rui colorectal cancer patients with central lymph node metastasis and CK20 immunohistochemical lymph node micrometastasis and survival and other factors were analyzed in 2007-2008. Results: N3 lymph node metastasis occurred in 10.26% (4/39) of patients; N3 lymph node micrometastasis occurred in 17.95% (7/39) of patients; the tumor infiltration intestine was> 1/3 weeks, Patients with cancerous nodules and Dukes staging are more likely to have micrometastases with high-grade lymph nodes and patients with high-grade lymph node micrometastasis with poor prognosis. Conclusion: CK20 immunohistochemical lymph node micrometastasis detection is simple, easy, better than HE staining; colorectal cancer in the direction of the D3 operation has clinical significance.